Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 13.515
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-33807477

RESUMO

Tai Chi is an effective exercise option for individuals with coronary heart disease or its associated risk factors. An accurate and systematic assessment of a Mandarin-speaking adults' self-efficacy in maintaining Tai Chi exercise is lacking. Mandarin Chinese has the most speakers worldwide. This study aimed to translate the Tai Chi Exercise Self-Efficacy scale and examine its psychometric properties. The 14-item Tai Chi Exercise Self-Efficacy scale was translated from English into Mandarin Chinese using a forward-translation, back-translation, committee approach, and pre-test procedure. Participants with coronary heart disease or risk factors (n = 140) enrolled in a cross-sectional study for scale validation. Confirmatory factor analysis indicated a good fit of the two-factor structure (Tai Chi exercise self-efficacy barriers and performance) to this sample. The translated scale demonstrated high internal consistency, with a Cronbach's α value of 0.97, and good test-retest reliability, with an intra-class correlation coefficient of 0.86 (p < 0.01). Participants with prior Tai Chi experience reported significantly higher scores than those without (p < 0.001), supporting known-group validity. A significant correlation was observed between the translated scale and total exercise per week (r = 0.37, p < 0.01), providing evidence of concurrent validity. The Mandarin Chinese version of the Tai Chi Exercise Self-Efficacy scale is a valid and reliable scale for Chinese adults with coronary heart disease or risk factors.


Assuntos
Doença das Coronárias , Tai Ji , Adulto , China , Doença das Coronárias/prevenção & controle , Estudos Transversais , Humanos , Psicometria , Reprodutibilidade dos Testes , Fatores de Risco , Autoeficácia , Inquéritos e Questionários
3.
Am J Public Health ; 111(5): 890-895, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33734841

RESUMO

Community-based risk factor modification is today an established approach to chronic disease control and public health practice. This article analyzes the shaping of the North Karelia Project (NKP), an early and influential formulation of the community approach that focused on coronary heart disease prevention in Finland. Instead of targeting only high-risk individuals, NKP aimed to change the culture of the local community. On the basis of archival material and interviews, I first trace the multiple origins of the notion of community in NKP, which combined "internal" factors (local risk factor distribution, the role given to the social environment in chronic disease prevention) and "external" influences (regional origin of the initiative, World Health Organization and national policy concepts of community control and primary health care). Second, I describe the shape of the community intervention in NKP. The project foregrounded social relationships as a way to educate the public and influence norms guiding individual behaviors while subordinating environmental changes of a more structural nature.


Assuntos
Doença das Coronárias/epidemiologia , Doença das Coronárias/prevenção & controle , Promoção da Saúde/organização & administração , Estilo de Vida , Doenças Cardiovasculares/prevenção & controle , Características Culturais , Finlândia/epidemiologia , Comportamentos Relacionados com a Saúde , Humanos , Hipercolesterolemia/epidemiologia , Hipercolesterolemia/prevenção & controle , Hipertensão/prevenção & controle , Fatores de Risco , Fumar/epidemiologia , Prevenção do Hábito de Fumar , Fatores Socioeconômicos
4.
Cochrane Database Syst Rev ; 2: CD003610, 2021 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-33704780

RESUMO

BACKGROUND: Coronary heart disease is the leading cause of mortality worldwide with approximately 7.4 million deaths each year. People with established coronary heart disease have a high risk of subsequent cardiovascular events including myocardial infarction, stroke, and cardiovascular death. Antibiotics might prevent such outcomes due to their antibacterial, antiinflammatory, and antioxidative effects. However, a randomised clinical trial and several observational studies have suggested that antibiotics may increase the risk of cardiovascular events and mortality. Furthermore, several non-Cochrane Reviews, that are now outdated, have assessed the effects of antibiotics for coronary heart disease and have shown conflicting results. No previous systematic review using Cochrane methodology has assessed the effects of antibiotics for coronary heart disease. OBJECTIVES: We assessed the benefits and harms of antibiotics compared with placebo or no intervention for the secondary prevention of coronary heart disease. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, LILACS, SCI-EXPANDED, and BIOSIS in December 2019 in order to identify relevant trials. Additionally, we searched TRIP, Google Scholar, and nine trial registries in December 2019. We also contacted 11 pharmaceutical companies and searched the reference lists of included trials, previous systematic reviews, and other types of reviews. SELECTION CRITERIA: Randomised clinical trials assessing the effects of antibiotics versus placebo or no intervention for secondary prevention of coronary heart disease in adult participants (≥18 years). Trials were included irrespective of setting, blinding, publication status, publication year, language, and reporting of our outcomes. DATA COLLECTION AND ANALYSIS: Three review authors independently extracted data. Our primary outcomes were all-cause mortality, serious adverse event according to the International Conference on Harmonization - Good Clinical Practice (ICH-GCP), and quality of life. Our secondary outcomes were cardiovascular mortality, myocardial infarction, stroke, and sudden cardiac death. Our primary time point of interest was at maximum follow-up. Additionally, we extracted outcome data at 24±6 months follow-up. We assessed the risks of systematic errors using Cochrane 'Rosk of bias' tool. We calculated risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous outcomes. We calculated absolute risk reduction (ARR) or increase (ARI) and number needed to treat for an additional beneficial outcome (NNTB) or for an additional harmful outcome (NNTH) if the outcome result showed a beneficial or harmful effect, respectively. The certainty of the body of evidence was assessed by GRADE. MAIN RESULTS: We included 38 trials randomising a total of 26,638 participants (mean age 61.6 years), with 23/38 trials reporting data on 26,078 participants that could be meta-analysed. Three trials were at low risk of bias and the 35 remaining trials were at high risk of bias. Trials assessing the effects of macrolides (28 trials; 22,059 participants) and quinolones (two trials; 4162 participants) contributed with the vast majority of the data. Meta-analyses at maximum follow-up showed that antibiotics versus placebo or no intervention seemed to increase the risk of all-cause mortality (RR 1.06; 95% CI 0.99 to 1.13; P = 0.07; I2 = 0%; ARI 0.48%; NNTH 208; 25,774 participants; 20 trials; high certainty of evidence), stroke (RR 1.14; 95% CI 1.00 to 1.29; P = 0.04; I2 = 0%; ARI 0.73%; NNTH 138; 14,774 participants; 9 trials; high certainty of evidence), and probably also cardiovascular mortality (RR 1.11; 95% CI 0.98 to 1.25; P = 0.11; I2= 0%; 4674 participants; 2 trials; moderate certainty of evidence). Little to no difference was observed when assessing the risk of myocardial infarction (RR 0.95; 95% CI 0.88 to 1.03; P = 0.23; I2 = 0%; 25,523 participants; 17 trials; high certainty of evidence). No evidence of a difference was observed when assessing sudden cardiac death (RR 1.08; 95% CI 0.90 to 1.31; P = 0.41; I2 = 0%; 4520 participants; 2 trials; moderate certainty of evidence). Meta-analyses at 24±6 months follow-up showed that antibiotics versus placebo or no intervention increased the risk of all-cause mortality (RR 1.25; 95% CI 1.06 to 1.48; P = 0.007; I2 = 0%; ARI 1.26%; NNTH 79 (95% CI 335 to 42); 9517 participants; 6 trials; high certainty of evidence), cardiovascular mortality (RR 1.50; 95% CI 1.17 to 1.91; P = 0.001; I2 = 0%; ARI 1.12%; NNTH 89 (95% CI 261 to 49); 9044 participants; 5 trials; high certainty of evidence), and probably also sudden cardiac death (RR 1.77; 95% CI 1.28 to 2.44; P = 0.0005; I2 = 0%; ARI 1.9%; NNTH 53 (95% CI 145 to 28); 4520 participants; 2 trials; moderate certainty of evidence). No evidence of a difference was observed when assessing the risk of myocardial infarction (RR 0.95; 95% CI 0.82 to 1.11; P = 0.53; I2 = 43%; 9457 participants; 5 trials; moderate certainty of evidence) and stroke (RR 1.17; 95% CI 0.90 to 1.52; P = 0.24; I2 = 0%; 9457 participants; 5 trials; high certainty of evidence). Meta-analyses of trials at low risk of bias differed from the overall analyses when assessing cardiovascular mortality at maximum follow-up. For all other outcomes, meta-analyses of trials at low risk of bias did not differ from the overall analyses. None of the trials specifically assessed serious adverse event according to ICH-GCP. No data were found on quality of life. AUTHORS' CONCLUSIONS: Our present review indicates that antibiotics (macrolides or quinolones) for secondary prevention of coronary heart disease seem harmful when assessing the risk of all-cause mortality, cardiovascular mortality, and stroke at maximum follow-up and all-cause mortality, cardiovascular mortality, and sudden cardiac death at 24±6 months follow-up. Current evidence does, therefore, not support the clinical use of macrolides and quinolones for the secondary prevention of coronary heart disease. Future trials on the safety of macrolides or quinolones for the secondary prevention in patients with coronary heart disease do not seem ethical. In general, randomised clinical trials assessing the effects of antibiotics, especially macrolides and quinolones, need longer follow-up so that late-occurring adverse events can also be assessed.


Assuntos
Antibacterianos/efeitos adversos , Doença das Coronárias/prevenção & controle , Prevenção Secundária/métodos , Antibacterianos/uso terapêutico , Doenças Cardiovasculares/mortalidade , Causas de Morte , Doença das Coronárias/mortalidade , Morte Súbita Cardíaca/epidemiologia , Humanos , Macrolídeos/efeitos adversos , Macrolídeos/uso terapêutico , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Quinolonas/efeitos adversos , Quinolonas/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/epidemiologia
5.
Nutrients ; 13(2)2021 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-33562015

RESUMO

The Special Turku Coronary Risk Factor Intervention Project (STRIP) is a prospective infancy-onset randomized dietary intervention trial targeting dietary fat quality and cholesterol intake, and favoring consumption of vegetables, fruit, and whole-grains. Diet (food records) and circulating metabolites were studied at six time points between the ages of 9-19 years (n = 549-338). Dietary targets for this study were defined as (1) the ratio of saturated fat (SAFA) to monounsaturated and polyunsaturated fatty acids (MUFA + PUFA) < 1:2, (2) intake of SAFA < 10% of total energy intake, (3) fiber intake ≥ 80th age-specific percentile, and (4) sucrose intake ≤ 20th age-specific percentile. Metabolic biomarkers were quantified by high-throughput nuclear magnetic resonance metabolomics. Better adherence to the dietary targets, regardless of study group allocation, was assoiated with higher serum proportion of PUFAs, lower serum proportion of SAFAs, and a higher degree of unsaturation of fatty acids. Achieving ≥ 1 dietary target resulted in higher low-density lipoprotein (LDL) particle size, lower circulating LDL subclass lipid concentrations, and lower circulating lipid concentrations in medium and small high-density lipoprotein subclasses compared to meeting 0 targets. Attaining more dietary targets (≥2) was associated with a tendency to lower lipid concentrations of intermediate-density lipoprotein and very low-density lipoprotein subclasses. Thus, adherence to dietary targets is favorably associated with multiple circulating fatty acids and lipoprotein subclass lipid concentrations, indicative of better cardio-metabolic health.


Assuntos
Doença das Coronárias/prevenção & controle , Dieta Saudável/estatística & dados numéricos , Ingestão de Alimentos/fisiologia , Comportamento Alimentar/fisiologia , Fidelidade a Diretrizes/estatística & dados numéricos , Adolescente , Biomarcadores/sangue , Criança , Pré-Escolar , Colesterol na Dieta/análise , LDL-Colesterol/sangue , Registros de Dieta , Dieta Saudável/métodos , Dieta Saudável/normas , Gorduras na Dieta/análise , Fibras na Dieta/análise , Ingestão de Energia , Ácidos Graxos/sangue , Ácidos Graxos Monoinsaturados/sangue , Ácidos Graxos Insaturados/sangue , Feminino , Finlândia , Frutas , Fatores de Risco de Doenças Cardíacas , Humanos , Lactente , Lipídeos/sangue , Masculino , Metabolômica , Política Nutricional , Estudos Prospectivos , Verduras , Grãos Integrais , Adulto Jovem
6.
Nutrients ; 13(2)2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33572980

RESUMO

Coronary heart disease (CHD) is one of the leading causes of mortality in many low-income and middle-income countries, including Indonesia, with elevated blood cholesterol level being one of significant risk factors for this condition. The problem should be addressed by combining healthy lifestyle and diet, where functional foods having a cholesterol-lowering activity could play a significant role. A group of compounds that had been proven to show cholesterol-lowering ability are plant sterols. To develop more suitable functional foods that could substantially contribute to hypercholesterolemia prevention in Indonesian population, up-to-date data about plant sterols dietary intake are required, and were not available until this research was done. This study aimed to estimate daily plant sterols intake and to determine the consumption pattern of foods containing plant sterols in rural and urban area of Bogor, West Java, Indonesia. The research was conducted with a cross-sectional design, with 200 respondents. The study revealed that the level of plant sterols intake in Bogor reached on average 229.76 mg/day and was not significantly different between urban and rural area. Cereals, vegetables, and fruit products were the main food sources of plant sterols in both areas. In addition, a list of several surveyed food items possible to be enriched with plant sterols was developed within the study. These results provide baseline data to develop functional foods fortified with plant sterols suitable for the Indonesian needs and taste. However, further studies are needed to confirm efficacy and safety of introducing such phytosterol-enriched products into a habitual diet, especially considering possible long-term side effects of plant sterol treatment.


Assuntos
Anticolesterolemiantes/análise , Doença das Coronárias/prevenção & controle , Dieta/estatística & dados numéricos , Hipercolesterolemia/prevenção & controle , Fitosteróis/análise , Adulto , Idoso , Colesterol/sangue , Doença das Coronárias/etiologia , Estudos Transversais , Dieta/efeitos adversos , Dieta/métodos , Inquéritos sobre Dietas , Ingestão de Alimentos/fisiologia , Comportamento Alimentar/fisiologia , Feminino , Ingredientes de Alimentos , Alimentos Fortificados , Alimento Funcional , Humanos , Hipercolesterolemia/etiologia , Indonésia , Masculino , Pessoa de Meia-Idade
7.
BMC Cardiovasc Disord ; 21(1): 44, 2021 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-33478404

RESUMO

BACKGROUND: Adherence to clinical practice guidelines for coronary heart disease (CHD) reduces morbidity, mortality and treatment costs. We aimed to describe and compare adherence to prescription guidelines for persons with CHD, and explore its association with treatment goal achievement. METHOD: We included all participants reporting myocardial infarction, angina, percutaneous coronary intervention and/or coronary artery bypass surgery in the seventh wave of the Tromsø Study (2015-2016, n = 1483). Medication use and treatment goal measures (blood pressure, low-density lipoprotein (LDL)-cholesterol and HbA1c) were compared to clinical practice guidelines on secondary CHD prevention. Propensity score matched logistic regression was used to assess the association between the use of antihypertensive drugs and achievement of treatment goal for blood pressure, and the use of lipid-lowering drugs (LLDs) and achievement of treatment goal for LDL-cholesterol. RESULTS: The prevalence of pharmacological CHD treatment was 76% for LLDs, 72% for antihypertensive drugs and 66% for acetylsalicylic acid. The blood pressure goal (< 140/90 mmHg, < 140/80 mmHg if diabetic) was achieved by 58% and the LDL-cholesterol goal (< 1.8 mmol/l or < 70 mg/dL) by 9%. There was a strong association between using LLDs and achieving the treatment goal for LDL-cholesterol (OR 14.0, 95% CI 3.6-54.7), but not between using antihypertensive drugs and blood pressure goal achievement (OR 1.4, 95% CI 0.7-2.7). CONCLUSION: Treatment goal achievement of LDL-cholesterol and blood pressure was low, despite the relatively high use of LLDs and antihypertensive drugs. Further research is needed to find the proper actions to increase achievement of the treatment goals.


Assuntos
Anti-Hipertensivos/uso terapêutico , Doença das Coronárias/prevenção & controle , Fidelidade a Diretrizes/tendências , Hiperlipidemias/tratamento farmacológico , Hipertensão/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/tendências , Prevenção Secundária/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Pressão Sanguínea/efeitos dos fármacos , LDL-Colesterol/metabolismo , Doença das Coronárias/diagnóstico , Feminino , Hemoglobina A Glicada/metabolismo , Fatores de Risco de Doenças Cardíacas , Humanos , Hiperlipidemias/sangue , Hiperlipidemias/diagnóstico , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Noruega , Medição de Risco , Fatores de Tempo , Resultado do Tratamento
8.
Am J Cardiol ; 145: 1-11, 2021 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-33454343

RESUMO

The secondary prevention (SP) of coronary heart disease (CHD) has become a major public health and economic burden worldwide. In the United States, the prevalence of CHD has risen to 18 million, the incidence of recurrent myocardial infarctions (MI) remains high, and related healthcare costs are projected to double by 2035. In the last decade, practice guidelines and performance measures for the SP of CHD have increasingly emphasized evidence-based lifestyle (LS) interventions, including healthy dietary patterns, regular exercise, smoking cessation, weight management, depression screening, and enrollment in cardiac rehabilitation. However, data show large gaps in adherence to healthy LS behaviors and low rates of enrollment in cardiac rehabilitation in patients with established CHD. These gaps may be related, since behavior change interventions have not been well integrated into traditional ambulatory care models in the United States. The chronic care model, an evidence-based practice framework that incorporates clinical decision support, self-management support, team-care delivery and other strategies for delivering chronic care is well suited for both chronic CHD management and prevention interventions, including those related to behavior change. This article reviews the evidence base for LS interventions for the SP of CHD, discusses current gaps in adherence, and presents strategies for closing these gaps via evidence-based and emerging interventions that are conceptually aligned with the elements of the chronic care model.


Assuntos
Reabilitação Cardíaca , Doença das Coronárias/prevenção & controle , Dieta , Exercício Físico , Cooperação do Paciente , Prevenção Secundária/métodos , Abandono do Hábito de Fumar , Sistemas de Apoio a Decisões Clínicas , Atenção à Saúde , Depressão/diagnóstico , Depressão/terapia , Dieta Mediterrânea , Dieta Vegetariana , Abordagens Dietéticas para Conter a Hipertensão , Humanos , Estilo de Vida , Programas de Rastreamento , Atenção Plena , Comportamento de Redução do Risco , Autogestão , Estresse Psicológico/terapia
9.
Nutr Metab Cardiovasc Dis ; 30(8): 1315-1321, 2020 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-32513579

RESUMO

BACKGROUND AND AIM: Along with the increasing evidence of the cardioprotective effects of the Mediterranean Diet (MD), the scientific interest and advocacy of dietary variety as a potentially healthy eating habit gradually faded, until its complete oblivion in the latest European cardiovascular prevention guidelines. Our study aims to investigate whether dietary variety adds to the "Mediterranean-ness" of the diet in protecting against coronary heart disease (CHD). METHODS AND RESULTS: In this case-control Italian study, data on eating habits were collected from 178 patients with CHD and 155 healthy controls, primarily males, frequency matched for age and gender, using the Food Frequency Questionnaire (FFQ) of the European Prospective Investigation into Cancer and Nutrition. Adherence to MD was estimated from FFQ by the Mediterranean Diet Score (MDS), an index developed by Trichopoulou (2003) ranging from 0 to 9, with higher scores indicating a stricter adherence. Overall dietary variety was computed from FFQ as a count of single food items consumed at least once a month. Associations between MDS or overall dietary variety and coronary status were evaluated by logistic regression models adjusted for BMI, physical activity, smoking, education, and caloric intake; the Odds Ratio (OR) for CHD for each 1.5-point increase in MDS was 0.76 [IC 95% 0.59; 0.98], whereas the OR for CHD for each 15-item increase in dietary variety was 0.62 [IC 95% 0.46; 0.84]. Remarkably, adherence to MD and overall dietary variety were independently associated with a significantly reduced chance of CHD. CONCLUSION: Dietary Mediterranean-ness and overall dietary variety exhibit additive cardioprotective effects.


Assuntos
Doença das Coronárias/prevenção & controle , Dieta Saudável , Dieta Mediterrânea , Comportamento Alimentar , Valor Nutritivo , Comportamento de Redução do Risco , Idoso , Doença das Coronárias/diagnóstico , Doença das Coronárias/epidemiologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Recomendações Nutricionais , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
10.
Am J Physiol Heart Circ Physiol ; 319(1): H76-H88, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32442027

RESUMO

Blood lipoproteins are formed by various amounts of cholesterol (C), triglycerides (TGs), phospholipids, and apolipoproteins (Apos). ApoA1 is the major structural protein of high-density lipoprotein (HDL), accounting for ~70% of HDL protein, and mediates many of the antiatherogenic functions of HDL. Conversely, ApoB is the predominant low-density lipoprotein (LDL) Apo and is an indicator of circulating LDL, associated with higher coronary heart disease (CHD) risk. Thus, the ratio of ApoB to ApoA1 (ApoB/ApoA1) is used as a surrogate marker of the risk of CHD related to lipoproteins. Elevated or abnormal levels of lipids and/or lipoproteins in the blood are a significant CHD risk factor, and several studies support the idea that aerobic exercise decreases CHD risk by partially lowering serum TG and LDL-cholesterol (LDL-C) levels and increasing HDL-C levels. Exercise also exerts an effect on HDL-C maturation and composition and on reverse C transport from peripheral cells to the liver to favor its catabolism and excretion. This process prevents atherosclerosis, and several studies showed that exercise training increases heart lipid metabolism and protects against cardiovascular disease. In these and other ways, it more and more appears that regular exercise, nutrition, and strategies to modulate lipid profile should be viewed as an integrated whole. The purpose of this review is to assess the effects of endurance training on the nontraditional lipid biomarkers, including ApoB, ApoA1, and ApoB/ApoA1, in CHD risk.


Assuntos
Doença das Coronárias/prevenção & controle , Exercício Físico , Metabolismo dos Lipídeos , Apolipoproteínas/sangue , Doença das Coronárias/sangue , Doença das Coronárias/etiologia , Humanos
11.
Ann Cardiol Angeiol (Paris) ; 69(3): 107-114, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32303363

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells with angiotensin receptors, leading to pneumonia linked to COVID-19. The virus has a double impact on the cardiovascular system, the infection will be more intense if the host has cardiovascular co-morbidities and the virus can cause life-threatening cardiovascular lesions. Therapies associated with COVID-19 may have adverse cardiovascular effects. Therefore, special attention should be given to cardiovascular protection during COVID-19 infection.


Assuntos
Betacoronavirus/patogenicidade , Doenças Cardiovasculares/complicações , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Antimaláricos/efeitos adversos , Antimaláricos/uso terapêutico , Antivirais/efeitos adversos , Antivirais/uso terapêutico , Azitromicina/efeitos adversos , Azitromicina/uso terapêutico , Betacoronavirus/imunologia , Cardiomiopatias/virologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/prevenção & controle , Transtornos Cerebrovasculares/virologia , Cloroquina/efeitos adversos , Cloroquina/uso terapêutico , Comorbidade , Doença das Coronárias/complicações , Doença das Coronárias/prevenção & controle , Doença das Coronárias/virologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Interações Medicamentosas , Quimioterapia Combinada/efeitos adversos , Feminino , Humanos , Hidroxicloroquina/efeitos adversos , Hidroxicloroquina/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Metilprednisolona/efeitos adversos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Fatores de Risco , Internalização do Vírus/efeitos dos fármacos
12.
Nutr Metab Cardiovasc Dis ; 30(6): 853-871, 2020 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-32278608

RESUMO

BACKGROUND AND AIMS: Despite the proven evidence of high glycemic index (GI) and glycemic load (GL) diets to increase cardiometabolic risks, knowledge about the meta-evidence for carbohydrate quality within world geographic regions is limited. We conducted a meta-analysis to synthesize the evidence of GI/GL studies and carbohydrate quality, gathering additional exposures for carbohydrate, high glycemic carbohydrate, total dietary fiber, and cereal fiber and risks for type 2 diabetes (T2DM), coronary heart disease (CHD), stroke, and mortality, grouped into the US, Europe, and Asia. Secondary aims examined cardiometabolic risks in overweight/obese individuals, by sex, and dose-response dietary variable trends. METHODS AND RESULTS: 40-prospective observational studies from 4-Medline bibliographical databases (Ovid, PubMed, EBSCOhost, CINAHL) were search up to November 2019. Random-effects hazard ratios (HR) and 95% confidence intervals (CI) for highest vs. lowest categories and continuous form combined were reported. Heterogeneity (I2>50%) was frequent in US GI/GL studies due to differing study characteristics. Increased risks ((HRGI,T2DM,US=1.14;CI:1.06,1.21), HRGL,T2DM,US=1.02 (1.01, 1.03)), HRGI,T2DM,Asia=1.25;1.02,1.53), and HRGL,T2DM,Asia=1.37 (1.17, 1.60)) were associated with cardiometabolic diseases. GI/GL in overweight/obese females had the strongest magnitude of risks in US-and Asian studies. Total dietary fiber (HRT2DM,US = 0.92;0.88,0.96) and cereal fiber (HRT2DM,US = 0.83;0.77,0.90) decreased risk of developing T2DM. Among females, we found protective dose-response risks for total dietary fiber (HR5g-total-dietary-fiber,T2DM,US = 0.94;0.92,0.97), but cereal fiber showed better ability to lower T2DM risk (HR5g-cereal-fiber,T2DM,US = 0.67;0.60,0.74). Total dietary-and cereal fibers' dose-response effects were nullified by GL, but not so for cereal fiber with GI. CONCLUSIONS: Overweight/obese females could shift their carbohydrate intake for higher cereal fiber to decrease T2DM risk, but higher GL may cancel-out this effect.


Assuntos
Glicemia/metabolismo , Doença das Coronárias/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Carboidratos da Dieta/administração & dosagem , Índice Glicêmico , Carga Glicêmica , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Biomarcadores/sangue , Doença das Coronárias/diagnóstico , Doença das Coronárias/mortalidade , Doença das Coronárias/prevenção & controle , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/mortalidade , Diabetes Mellitus Tipo 2/prevenção & controle , Carboidratos da Dieta/efeitos adversos , Carboidratos da Dieta/sangue , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Observacionais como Assunto , Prognóstico , Medição de Risco , Fatores de Risco , Fatores Sexuais , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/prevenção & controle , Estados Unidos/epidemiologia , Adulto Jovem
14.
Nutr. hosp ; 37(2): 313-320, mar.-abr. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-190596

RESUMO

INTRODUCTION: dietary fat has been reported as one of the significant risk factors in the development of cardiovascular diseases (CVD). OBJECTIVE: this study aimed at assessing the possible association between fat intake and CVD. METHODS: the present case-control study was conducted in the center of coronary angiography. Three-hundred and ninety nine patients who referred for elective coronary angiography with clinical suspicion of coronary artery disease were enrolled. Dietary data were collected from each patient using an interview-based food frequency questionnaire. RESULTS: the findings of the present study revealed no significant differences between cases and controls regarding the intake of all types of fat either before or after energy adjustment. For both cases and controls the percentage of fat intake from total energy and the intakes of polyunsaturated and monounsaturated fats, cholesterol, omega-6 and omega-3 were within the recommended amounts. The intake of all fat types (except trans-fat) was not associated with the risk of developing CVD. Trans-fat intake in the second and third quartile increased the risk of CVD by OR 1.86 (95 % CI: 1.03-3.34) and 2.01 (95 % CI: 1.12-3.60), respectively. CONCLUSIONS: while trans-fats may be significantly associated with the development of CVD in the first two quartiles, no association has been detected with other fat types


INTRODUCCIÓN: se ha establecido que la grasa en la dieta es uno de los factores de riesgo significativos en el desarrollo de enfermedades cardiovasculares (ECV). OBJETIVO: este estudio tuvo como objetivo evaluar la posible asociación entre la ingesta de grasa y la ECV. MÉTODOS: el presente estudio de casos y controles se realizó en el centro de la angiografía coronaria. Se inscribieron 399 pacientes que fueron remitidos para una angiografía coronaria electiva con sospecha clínica de enfermedad coronaria. Los datos dietéticos se obtuvieron de cada paciente mediante un cuestionario de frecuencia de alimentos basado en entrevistas. RESULTADOS: los hallazgos del presente estudio no revelaron diferencias significativas entre los casos y los controles con respecto a la ingesta de todos los tipos de grasa, ya sea antes o después del ajuste de energía. Para ambos casos y controles, el porcentaje de ingesta de grasas de la energía total y las ingestas de grasas poliinsaturadas y monoinsaturadas, colesterol, omega-6 y omega-3 se encuentran dentro de las cantidades recomendadas. La ingesta de todos los tipos de grasa (excepto las grasas trans) no se asoció con el riesgo de desarrollar ECV. La ingesta de grasas trans en el segundo y tercer cuartil aumentó el riesgo de ECV en OR 1,86 (IC 95 %: 1,03-3,34) y 2,01 (IC 95 %: 1,12-3,60), respectivamente. CONCLUSIONES: si bien las grasas trans pueden estar asociadas significativamente con el desarrollo de ECV en los dos primeros cuartiles, no se ha detectado asociación con otros tipos de grasa


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Dieta Hiperlipídica/efeitos adversos , Doença das Coronárias/complicações , Gorduras na Dieta/efeitos adversos , Doença das Coronárias/diagnóstico , Gorduras na Dieta/administração & dosagem , Doença das Coronárias/prevenção & controle , Fatores de Risco , Dieta com Restrição de Gorduras/métodos , Inquéritos Nutricionais
15.
Sci Rep ; 10(1): 4090, 2020 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-32139725

RESUMO

Studies on the influence of a modern lifestyle in abetting Coronary Heart Diseases (CHD) have mostly focused on deterrent health factors, like smoking, alcohol intake, cheese consumption and average systolic blood pressure, largely disregarding the impact of a healthy lifestyle in mitigating CHD risk. In this study, 30+ years' World Health Organization (WHO) data have been analyzed, using a wide array of advanced Machine Learning techniques, to quantify how regulated reliance on positive health indicators, e.g. fruits/vegetables, cereals can offset CHD risk factors over a period of time. Our research ranks the impact of the negative outliers on CHD and then quantifies the impact of the positive health factors in mitigating the negative risk-factors. Our research outcomes, presented through simple mathematical equations, outline the best CHD prevention strategy using lifestyle control only. We show that a 20% increase in the intake of fruit/vegetable leads to 3-6% decrease in SBP; or, a 10% increase in cereal intake lowers SBP by 3%; a simultaneous increase of 10% in fruit-vegetable can further offset the effects of SBP by 6%. Our analysis establishes gender independence of lifestyle on CHD, refuting long held assumptions and unqualified beliefs. We show that CHD risk can be lowered with incremental changes in lifestyle and diet, e.g. fruit-vegetable intake ameliorating effects of alcohol-smoking-fatty food. Our multivariate data model also estimates functional relationships amongst lifestyle factors that can potentially redefine the diagnostics of Framingham score-based CHD-prediction.


Assuntos
Doença das Coronárias/prevenção & controle , Dieta , Estilo de Vida Saudável , Aprendizado de Máquina , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Adulto Jovem
16.
Am J Cardiol ; 125(8): 1154-1157, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32088001

RESUMO

Clinical guidelines from the United States and Europe do not recommend treatment with statins for primary prevention in patients with hypercholesterolemia who are older than 75 years. Data from 35 randomized controlled trials in this age group where statin therapy for primary prevention was compared with placebo or usual care were analyzed. Using all-cause death as the outcome, we performed 2 types of analyses: frequentist and Bayesian. Frequentist analysis indicated no significant difference in mortality between cases (on statins) and controls (on placebo or usual care, p = 0.16). However, in the Bayesian analysis, patients >75 years had lower mortality from treatment with statins (p = 0.03). In conclusion, Bayesian analysis indicates a definite, statistically significant and clinically relevant benefit of statin treatment for primary prevention in patients >75 years of age.


Assuntos
Doença das Coronárias/prevenção & controle , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipercolesterolemia/tratamento farmacológico , Mortalidade , Prevenção Primária , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Causas de Morte , Humanos , Seleção de Pacientes
17.
Nutr Cancer ; 72(1): 1-4, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31842617

RESUMO

Was the Annals of Internal Medicine recently acting as a mouthpiece for meat-industry propaganda? Five papers underpinned recommendations on meat consumption; their central deceit was to review only randomized controlled trials and cohort studies, which, in research on the associations between common foods and disease outcomes, are nearer to the bottom than the top of the evidence hierarchy. Despite concluding that their own recommendations were "weak and based on low certainty evidence", the authors were happy to recommend that there is "No need to reduce red or processed meat consumption for good health." What we actually know is that: red meat consumption is an order of magnitude higher now than through most of human history; red meat is a probable, and processed meat is a definite, human carcinogen; saturated fat increases risk of heart disease; and vegans and vegetarians have better lipid profiles, lower risk of chronic disease, and greater longevity than meat eaters. There are other consequences of meat consumption too, including: altered sexual development; widespread antimicrobial resistance; and disrupted planetary health, including depletion of aquifers, groundwater pollution, and increased greenhouse gases. The pseudoscience presented in the Annals of Internal Medicine appears to have been written solely to create doubt and confusion in the wider population. Scientists and journals should hold themselves to a higher standard.


Assuntos
Manteiga/efeitos adversos , Doença das Coronárias/etiologia , Dieta/efeitos adversos , Comportamento Alimentar/psicologia , Neoplasias/etiologia , Carne Vermelha/efeitos adversos , Vegetarianos/estatística & dados numéricos , Estudos de Coortes , Doença das Coronárias/prevenção & controle , Humanos , Carne/efeitos adversos , Neoplasias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco
18.
Qual Life Res ; 29(4): 971-975, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31722083

RESUMO

PURPOSE: To study the predictive ability of each of the eight scales of SF-36 on 13-year all-cause mortality and incident coronary heart disease (CHD) in a general middle-aged population. METHODS: The population-based, longitudinal "Life-conditions, Stress and Health" study, in 2003-2004 enrolled 1007 persons aged 45-69 years (50% female), randomly sampled from the general population in Östergötland, Sweden. Variables at baseline included the SF-36 (health-related quality of life, HRQoL) and self-reported disease. Incident CHD (morbidity and mortality) and all-cause mortality data for the study population during the first 13 years from baseline were obtained from national Swedish registries. RESULTS: Seven of the eight SF-36 scales predicted CHD (sex- and age-adjusted Hazard Ratios up to 2.15; p ≤ 0.05), while only the Physical Functioning scale significantly predicted all-cause mortality. Further adjustments for presence of (self-reported) disease did not, in most cases, alter these significant predictions. CONCLUSION: Low SF-36 scores predict risk of CHD, also after adjustment for present disease, supporting the biopsychosocial model of health and disease. Measures of HRQoL yield important information and can add to the cardiopreventive toolbox, including primary prevention efforts, as it is such a simple and relatively inexpensive tool.


Assuntos
Doença das Coronárias/epidemiologia , Doença das Coronárias/mortalidade , Inquéritos Epidemiológicos/métodos , Qualidade de Vida/psicologia , Idoso , Doença das Coronárias/prevenção & controle , Feminino , Nível de Saúde , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Sistema de Registros , Autorrelato , Suécia/epidemiologia
19.
J Atheroscler Thromb ; 27(2): 105-118, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31748469

RESUMO

Animal models that closely resemble both human disease findings and their onset mechanism have contributed to the advancement of biomedical science. The Watanabe heritable hyperlipidemic (WHHL) rabbit and its advanced strains (the coronary atherosclerosis-prone and the myocardial infarction-prone WHHL rabbits) developed at Kobe University (Kobe, Japan), an animal model of human familial hypercholesterolemia, have greatly contributed to the elucidation of the pathophysiology of human lipoprotein metabolism, hypercholesterolemia, atherosclerosis, and coronary heart disease, as described below. 1) The main part of human lipoprotein metabolism has been elucidated, and the low-density lipoprotein (LDL) receptor pathway hypothesis derived from studies using fibroblasts was proven in vivo. 2) Oxidized LDL accumulates in the arterial wall, monocyte adhesion molecules are expressed on arterial endothelial cells, and monocyte-derived macrophages infiltrate the arterial intima, resulting in the formation and progression of atherosclerosis. 3) Coronary lesions differ from aortic lesions in lesion composition. 4) Factors involved in the development of atherosclerosis differ between the coronary arteries and aorta. 5) The rupture of coronary lesions requires secondary mechanical forces, such as spasm, in addition to vulnerable plaques. 6) Specific lipid molecules in the blood have been identified as markers of the progression of coronary lesions. At the end of the breeding of the WHHL rabbit family at Kobe University, this review summarizes the history of the development of the WHHL rabbit family and their contribution to biomedical science.


Assuntos
Aterosclerose , Doença das Coronárias , Modelos Animais de Doenças , Hiperlipoproteinemia Tipo II , Coelhos , Animais , Aterosclerose/história , Aterosclerose/metabolismo , Aterosclerose/prevenção & controle , Doença das Coronárias/história , Doença das Coronárias/metabolismo , Doença das Coronárias/prevenção & controle , História do Século XX , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/história , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Hiperlipoproteinemia Tipo II/tratamento farmacológico , Hiperlipoproteinemia Tipo II/genética , Hiperlipoproteinemia Tipo II/história , Hiperlipoproteinemia Tipo II/metabolismo , Metabolismo dos Lipídeos/fisiologia
20.
Mol Med Rep ; 21(1): 151-160, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31746393

RESUMO

It has been universally acknowledged that interleukin­37 (IL­37) has an immunosuppressive effect on various inflammatory disorders. However, whether IL­37 participates in the acute inflammation associated with coronary heart disease (CHD) has not yet been clarified. In the present study, the association between the serum levels of IL­37 and the clinical indexes of CHD were analysed. In addition, the anti­inflammatory effects of IL­37 on peripheral blood mononuclear cells (PBMCs) were studied in CHD patients. PBMCs from 46 healthy controls (HCs) and 92 CHD patients were cultured in vitro and stimulated using the recombinant IL­37 protein. The protein levels, as well as the mRNA expression of inflammatory cytokines (TNF­α, IL­1ß, IL­6, and IL­17) were analysed by enzyme­linked immunosorbent assay (ELISA) and real­time polymerase chain reaction (RT­PCR). Spearman's correlation test was performed to examine the association between the serum level of IL­37 and the levels of pro­inflammatory cytokines, certain clinical indexes, and disease activity during CHD. Compared to the HCs, the CHD patients, especially those with acute myocardial infarction, exhibited higher levels of IL­37 in their PBMCs and sera. Serum levels of IL­37 were associated with the levels of IL­17, IL­6, and TNF­α, and clinical indexes such as the left ventricular ejection fraction (LVEF), amino­N­terminal pro­plasma brain natriuretic peptide (NT­proBNP) levels, and cardiac troponin T (cTnT) levels in CHD patients. Compared to the HC group, the production of inflammatory cytokines such as IL­17, IL­6, TNF­α, and IL­1ß increased in the PBMCs of CHD patients and significantly decreased after the stimulation of the cells with recombinant IL­37. The IL­37 levels in CHD patients were high, and were correlated with the levels of CHD­related pro­inflammatory cytokines and disease activity. Notably, the expression of CHD­related pro­inflammatory cytokines in the PBMCs of CHD patients decreased following the stimulation of the cells with recombinant IL­37, indicating that IL­37 exerts anti­inflammatory effects during CHD.


Assuntos
Doença das Coronárias/sangue , Interleucina-1/sangue , Leucócitos Mononucleares/metabolismo , Idoso , Doença das Coronárias/patologia , Doença das Coronárias/prevenção & controle , Feminino , Humanos , Inflamação/sangue , Inflamação/patologia , Inflamação/prevenção & controle , Interleucina-1/farmacologia , Leucócitos Mononucleares/patologia , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes/farmacologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...