Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.534
Filtrar
2.
BMJ ; 368: l6669, 2020 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915124

RESUMO

OBJECTIVE: To examine how a healthy lifestyle is related to life expectancy that is free from major chronic diseases. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: The Nurses' Health Study (1980-2014; n=73 196) and the Health Professionals Follow-Up Study (1986-2014; n=38 366). MAIN EXPOSURES: Five low risk lifestyle factors: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%). MAIN OUTCOME: Life expectancy free of diabetes, cardiovascular diseases, and cancer. RESULTS: The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years (95% confidence interval 22.6 to 24.7) for women who adopted no low risk lifestyle factors, in contrast to 34.4 years (33.1 to 35.5) for women who adopted four or five low risk factors. At age 50, the life expectancy free of any of these chronic diseases was 23.5 (22.3 to 24.7) years among men who adopted no low risk lifestyle factors and 31.1 (29.5 to 32.5) years in men who adopted four or five low risk lifestyle factors. For current male smokers who smoked heavily (≥15 cigarettes/day) or obese men and women (body mass index ≥30), their disease-free life expectancies accounted for the lowest proportion (≤75%) of total life expectancy at age 50. CONCLUSION: Adherence to a healthy lifestyle at mid-life is associated with a longer life expectancy free of major chronic diseases.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Estilo de Vida Saudável/fisiologia , Expectativa de Vida , Neoplasias , Comportamento de Redução do Risco , Adulto , Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/psicologia , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/psicologia , Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/prevenção & controle , Neoplasias/psicologia , Pesquisa em Enfermagem , Estudos Prospectivos , Fumar
3.
Mayo Clin Proc ; 94(12): 2390-2398, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31806097

RESUMO

OBJECTIVE: To determine the association between cost sharing and adherence to cardiac rehabilitation (CR). PATIENTS AND METHODS: We collected detailed cost-sharing information for patients enrolled in CR at Baystate Medical Center in Springfield, Massachusetts, including the presence (or absence) and amounts of co-pays and deductibles. We evaluated the association between cost sharing and the total number of CR sessions attended as well as the influence of household income on CR attendance. RESULTS: In 2015, 603 patients enrolled in CR had complete cost-sharing information. In total, 235 (39%) had some form of cost sharing. Of these, 192 (82%) had co-pays (median co-pay, $20; interquartile range [IQR], $10-$32) and 79 (34%) had an unmet deductible (median, $500; IQR, $250-$1800). The presence of any amount or form of cost sharing was associated with 6 fewer sessions of CR (16; IQR, 4-36 vs 10; IQR, 4-27; P<.001). Patients hospitalized in November or December with deductibles that renewed in January attended 4.5 fewer sessions of CR (8.5; IQR, 3.25-12.50 vs 13; IQR, 5.25-36.00; P=.049). After adjustment for differences in baseline characteristics, every $10 increase in co-pay was associated with 1.5 (95% CI, -2.3 to -0.7) fewer sessions of CR (P<.001). Household income did not moderate these relationships. CONCLUSION: Cost sharing was associated with lower CR attendance and exhibited a dose-response relationship such that higher cost sharing was associated with lower CR attendance. Given that CR is cost-effective and underutilized, insurance companies and other payers should reevaluate their cost-sharing policies for CR.


Assuntos
Reabilitação Cardíaca/estatística & dados numéricos , Doenças Cardiovasculares/economia , Doenças Cardiovasculares/psicologia , Custo Compartilhado de Seguro/economia , Cooperação do Paciente/estatística & dados numéricos , Idoso , Reabilitação Cardíaca/economia , Doenças Cardiovasculares/epidemiologia , Utilização de Instalações e Serviços , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
4.
Nurs Res ; 68(6): 445-452, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693550

RESUMO

BACKGROUND: The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health. OBJECTIVES: The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors. METHODS: This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores. RESULTS: Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c. DISCUSSION: This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.


Assuntos
Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/psicologia , Estresse Psicológico/epidemiologia , Adulto , Doenças Cardiovasculares/psicologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Autorrelato
5.
Ann Agric Environ Med ; 26(3): 456-461, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559803

RESUMO

INTRODUCTION AND OBJECTIVE: Stress at the work place reduces efficiency, as well as increasing accidents and absences, which may cause various diseases, including cardiovascular diseases. The aim of the study is an analysis of the prevalence and causes of stress in intellectual work, and its correlation with the prevalence of cardiovascular diseases in women at non-mobility working age. MATERIAL AND METHODS: The study was conducted in 2016-2017 in a group of 300 women aged 45-60 in non-manual employment. A questionnaire for subjective job evaluation was used. Logistic regression models for the occurrence of CVDs versus frequency of occurrence of individual causes of work stress among the respondents were estimated. RESULTS: Women at non-mobility working age with non-manual employment are especially exposed to stress, half of them experience high level of stress at work, most often caused by social contacts and lack of rewards and support. Cardiovascular diseases were found in 26.5% of the women studied who were also significantly higher exposed to the occurrence of health hazards due to exposure to harmful factors, or due to an accident at work, changes in the workplace, the need to compete with others,and the need to perform the task despite the lack of appropriate material resources, compared with women without such diseases. CONCLUSIONS: The study revealed a high prevalence of occupational stress in non-manual employment, indicated its main causes that correlated with the alence of cardiovascular diseases. Actions are needed to reduce the level of stress in the work of women at non-mobility working age, to maintain their work ability and quality of life.


Assuntos
Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/psicologia , Estresse Ocupacional , Local de Trabalho/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Estresse Psicológico
6.
Vnitr Lek ; 65(7-8): 483-489, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31487991

RESUMO

INTRODUCTION: The mental, physical and social stress and pressure of present day influences the incidence of cardiovascular diseases (CVD). Studies suggest that some psycho-social factors significantly increase the risk of CVD. But they are not paid the necessary attention. The goal of the study consisted in ascertaining how citizens assess their own mental health, how they perceive the influence of stress on CVD, how physicians and nurses work with them in the area of stress and how efficient their activity is. Research set and methods: The data ware collected via a non-standardized questionnaire leaded with face-to-face controlled interviews face-to-face. The analysis was carried out by the SASD 1.4 program with 1st degree and 2nd degree sorting. The goodness-of-fit χ2 was applied. The independence test at the level of significance α = 0.05, α = 0.01, α = 0.001 was calculated. We approached 2 306 randomly chosen citizens by quota selection. 314 citizens (13.6 %) refused the participation. The set consisted of 1 992 citizens (86.4 %) aged from 40 to 80 and more years, including 937 (47 %) men and 1055 (53 %) women. The relation of selected sociometric parameters was observed. RESULTS: The citizens aged 40 and more years assess their mental status as good (85 %), at the scale from 6 to 10, (1 the worst, 10 the best mental status). With increasing age, the mental status is assessed as worse at a significantly higher degree (p < 0.001). The mental status is assessed worse as the physical condition, with values 9 and 10. Out of the total number of the citizens approached, 87.9 % agree that stress influences the origination of CVD. Citizens from lower age groups (40-59 years) tend to think it (p.


Assuntos
Cardiologia , Doenças Cardiovasculares , Estresse Psicológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
7.
BMC Neurosci ; 20(1): 37, 2019 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366391

RESUMO

BACKGROUND: Cardiovascular conditions contribute to brain volume loss, reduced cerebrovascular health, and increased dementia risk in aging adults. Altered hippocampal connectivity has also been observed in individuals with cardiovascular conditions, yet the functional consequences of these changes remain unclear. In the present study, we collected functional magnetic resonance imaging data during memory encoding and used a psychophysiological interaction analysis to examine whether cardiovascular burden, indexed using the Framingham risk score, was associated with encoding-related hippocampal connectivity and task performance in cognitively-intact older adults between 65 and 85 years of age. Our goal was to better understand the early functional consequences of vascular and metabolic dysfunction in those at risk for cognitive decline. RESULTS: High Framingham risk scores were associated with lower total brain volumes. In addition, those with high Framingham risk scores showed an altered relationship between left hippocampal-medial prefrontal coupling and task performance compared to those with low Framingham risk scores. Specifically, we found a significant interaction of Framingham risk and learning on connectivity between the left hippocampus and primarily left midline prefrontal regions comprising the left ventral anterior cingulate cortex and medial prefrontal cortex. Those with lower Framingham risk scores showed a pattern of weaker connectivity between left hippocampal and medial prefrontal regions associated with better task performance. Those with higher Framingham risk scores showed the opposite pattern; stronger connectivity was associated with better performance. CONCLUSIONS: Findings from the current study show that amongst older adults with cardiovascular conditions, higher Framingham risk is associated with lower brain volume and altered left hippocampal-medial prefrontal coupling during task performance compared to those with lower Framingham risk scores. This may reflect a compensatory mechanism in support of memory function and suggests that older adults with elevated cardiovascular risk are vulnerable to early Alzheimer disease-like dysfunction within the episodic memory system.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/psicologia , Hipocampo/fisiopatologia , Córtex Pré-Frontal/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Neuroimagem Funcional , Humanos , Imagem por Ressonância Magnética , Masculino , Memória/fisiologia , Vias Neurais/fisiologia , Fatores de Risco
8.
Rev Assoc Med Bras (1992) ; 65(6): 801-809, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340308

RESUMO

BACKGROUND: Depression and anxiety disorders (DAD) are the most prevalent mental health conditions worldwide. Among the adult population served in basic care, it is estimated that depression affects about 14.3% of these individuals worldwide, and between 21.4% and 31% in Brasil. Anxiety affects up to 33.7% of the population during their lifetimes. OBJECTIVES: estimate the prevalence proportions of DAD among patients in a municipality in Northeast Brasil and study the association between DAD and cardiovascular risk factors. METHODS: a cross-sectional study with the medical records of patients from primary care centers in Jaboatão dos Guararapes, Pernambuco. Patients aged ≥ 18 years and regularly followed-up were included. Exclusion criteria: a history of traumatic brain injury, alcohol or drug abuse, previous stroke, medical conditions or medications that mimic DAD symptoms. Subjects were divided into two groups depending on the presence or absence of DAD, and cardiovascular risk factors were compared between groups. RESULTS: A total of 1030 subjects were initially included, of whom 215 (20%) were excluded. No-DAD subjects had more history of myocardial infarction and alcoholism. The prevalence of depression was 10.3%, anxiety disorder was 27.1%, and mixed DAD represented 4.5%. There was a significant association between DAD and hypertension (OR = 2.11; 95%CI: 1.16 -3.84; p=0.01), obesity (OR = 4.47; 95%CI: 1.74 -11.46; p=0.002), and hyperlipidemia (OR = 3.88; 95%CI: 1.81-8.3; p<0.001). CONCLUSION: DAD were associated with an increased risk for arterial hypertension, obesity, and hyperlipidemia.


Assuntos
Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/epidemiologia , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Estatísticas não Paramétricas
9.
Artigo em Inglês | MEDLINE | ID: mdl-31277211

RESUMO

Background: Chronic exposure to occupational stress may lead to negative health consequences. Creating less stressful work environments and making employees physically and psychologically more resilient against stress are therefore two major public health concerns. This study examined whether cardiorespiratory fitness moderated the association between occupational stress, cardiovascular risk, and mental health. Methods: Stress was assessed via the Effort-Reward Imbalance and Job Demand-Control models in 201 police officers (36% women, Mage = 38.6 years). Higher levels of blood pressure, blood lipids, blood sugar, and unfavorable body composition were considered as cardiovascular risk factors. Burnout, insomnia and overall psychological distress were used as mental health indicators. Cardiorespiratory fitness was assessed with a submaximal bicycle test. Results: High cardiorespiratory fitness levels were associated with a reduced cardiometabolic risk, whereas high stress levels were associated with better mental health. Among participants who perceived a high Effort-Reward Imbalance, those with high fitness levels showed lower overall cardiovascular risk scores than their colleagues with low fitness levels. Conclusions: Work health programs for police officers should consider the early screening of burnout, sleep disturbances, and overall mental wellbeing. To increase cardiovascular health, including fitness tests in routine health checks and promoting physical activity to further increase cardiorespiratory fitness appears worthwhile.


Assuntos
Aptidão Cardiorrespiratória , Doenças Cardiovasculares/epidemiologia , Saúde Mental , Estresse Ocupacional/psicologia , Polícia/psicologia , Adulto , Pressão Sanguínea , Doenças Cardiovasculares/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recompensa , Fatores de Risco
10.
Eur J Gen Pract ; 25(3): 143-148, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31280603

RESUMO

Background: Psychosocial factors such as depressive symptoms should be considered when assessing cardiovascular (CV) risk. Depressive symptoms are suggested to be associated with poor perception of one's health, i.e. self-rated health (SRH). Thus, assessing SRH could be a practical tool in CV risk prediction. However, SRH may also emphasize physical, mental or social aspects. Objectives: To assess the relationship of SRH and depressive symptoms, classic CV risk factors and perceived physical health among persons at risk for type 2 diabetes (T2D) and cardiovascular disease (CVD). Methods: In this cross-sectional study in a primary care population, 2555 persons (mean age 58 ± 7, 56% women) at risk for T2D or CVD were evaluated. Generalized linear statistical models were used to evaluate the association of depressive symptoms (Beck's Depression Inventory score ≥10), CV risk factors, and perception of SRH and physical health (assessed by Short Form Health Survey). Results: Poor or fair health was reported by 40% of the participants. They had more unhealthy lifestyle habits and CV risk factors than subjects rating their health as at least good. Among those with poor or fair SRH, the prevalence of depressive symptoms was 36% and associated with perception of physical health. Conclusion: Poor SRH is associated with depressive symptoms and impaired perceived physical health. Assessing SRH might be useful for detecting possible depressive symptoms in patients in CV risk management and diabetes care.


Assuntos
Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Nível de Saúde , Idoso , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/psicologia , Estudos Transversais , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/psicologia , Autoavaliação Diagnóstica , Feminino , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde , Fatores de Risco , Autorrelato
11.
Cardiol Young ; 29(6): 808-812, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31280730

RESUMO

BACKGROUND: Cardiovascular disease is a leading cause of morbidity and mortality in childhood cancer survivors. Cardiologists must be aware of risk factors and long-term follow-up guidelines, which have historically been the purview of oncologists. Little is known about paediatric cardiologists' knowledge regarding the cardiotoxicity of cancer treatment and how to improve this knowledge. METHODS: A total of 58 paediatric cardiologists anonymously completed a 21-question, web-based survey focused on four cardio-oncology themes: cancer treatment-related risk factors (n = 6), patient-related risk factors (n = 6), recommended surveillance (n = 3), and cardiac-specific considerations (n = 6). Following the baseline survey, a multi-disciplinary team of paediatric cardiologists and cancer survivor providers developed an in-person and web-based educational intervention. A post-intervention survey was conducted 5 months later. RESULTS: The response rate was 41/58 (70.7%) pre-intervention and 30/58 (51.7%) post-intervention. On the baseline survey, the percentage of correct answers was 68.8 ± 10.3%, which improved to 79.2 ± 16.2% after the intervention (p = 0.009). The theme with the most profound knowledge deficit was surveillance; however, it also had the greatest improvement after the intervention (49.6 ± 26.7 versus 66.7 ± 27.7% correct, p = 0.025). Individual questions with the largest per cent improvement pertained to risk of cardiac dysfunction with time since treatment (52.4 versus 93.1%, p = 0.002) and the role of dexrazoxane (48.8 versus 82.8%, p = 0.020). CONCLUSION: Specific knowledge deficits about the care of paediatric cancer survivors were identified amongst cardiologists using a web-based survey. Knowledge of surveillance was initially lowest but improved the most after an educational intervention. This highlights the need for cardio-oncology-based educational initiatives among paediatric cardiologists.


Assuntos
Antineoplásicos/efeitos adversos , Atitude do Pessoal de Saúde , Sobreviventes de Câncer , Cardiologistas/normas , Doenças Cardiovasculares/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias/tratamento farmacológico , Antineoplásicos/uso terapêutico , Cardiologistas/educação , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/epidemiologia , Criança , Seguimentos , Humanos , Incidência , Neoplasias/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida/tendências , Fatores de Tempo , Estados Unidos/epidemiologia
12.
BMC Public Health ; 19(1): 893, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286931

RESUMO

BACKGROUND: Mobilising non-professional health workers has been successful in improving community health, but the effectiveness of an education program targeting youths in a community-based approach remains unclear. The objective of this study was to investigate the effect of an intervention with youth on cardiovascular disease risk factors of community adults. METHODS: A 12-month cluster randomised trial was conducted in a semi-urban area of Colombo in Sri Lanka. Facilitators trained youth club members aged 15-29 years to assess cardiovascular disease risk factors and take actions in the community to address relevant issues. The control group received no intervention. Body weight and blood pressure as primary outcomes and lifestyle of adults as secondary outcomes were measured pre- and post-intervention. Multilevel linear and logistic regressions were used to assess the effects of the intervention on changes in continuous and binary outcomes, respectively, from baseline to endpoint. RESULTS: Of 512 participants at baseline, 483 completed the final assessment after the intervention. Regarding primary outcomes, the intervention group showed a significantly greater decrease in body weight after intervention than the control group. The mean (95% confidence interval) difference of body weight change for intervention versus control group was - 2.83 kg (- 3.31, - 2.35). There was no statistically significant difference in blood pressure between the two groups. Turning to the secondary outcomes, in diet, the intervention group had a higher probability of consuming at least one serving/day of fruits (p = 0.02) and a lower probability of consuming snacks twice/day or more (p < 0.001) than the control group. CONCLUSIONS: An intervention employing youths as change agents was effective in lowering body weight among community adults in Sri Lanka. TRIAL REGISTRATION: Trial registration number: SLCTR/2017/002 , Name of registry: Sri Lanka Clinical Trials Registry, Date of registration: 19th January 2017, Date of enrolment of the first participant to the trial: 1st February 2017.


Assuntos
Doenças Cardiovasculares/psicologia , Educação em Saúde/métodos , Relações Interpessoais , Características de Residência , Comportamento de Redução do Risco , Adolescente , Adulto , Pressão Sanguínea , Determinação da Pressão Arterial , Peso Corporal , Doenças Cardiovasculares/etiologia , Análise por Conglomerados , Dieta , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Estilo de Vida , Modelos Lineares , Masculino , Análise Multinível , Fatores de Risco , Sri Lanka , Adulto Jovem
13.
Int J Behav Med ; 26(4): 331-342, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31236872

RESUMO

BACKGROUND: Metabolic syndrome (MetS) is a group of cardiovascular risk factors including elevated blood pressure, elevated triglycerides, decreased high-density lipoprotein cholesterol, impaired fasting glucose, and abdominal obesity, which disproportionately affects Hispanics/Latinos. The present study examined associations between perceived discrimination and MetS in Hispanic/Latino adults from various background groups (i.e., Dominican, Central American, Cuban, Mexican, Puerto Rican, South American). METHODS: Data were obtained from 5174 Hispanics/Latinos who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. MetS components and covariates were measured at a baseline examination, and perceived discrimination was assessed within 9 months of baseline. Path analysis modeled associations of perceived discrimination with MetS prevalence and each of the six components of MetS, controlling for age, sex, income, acculturation, physical activity, diet, smoking, and alcohol use. RESULTS: Among the full cohort, perceived discrimination was not associated with MetS prevalence in any of the models evaluated. Higher perceived discrimination at work/school was associated with larger waist circumference. When examining background groups separately, higher perceived ethnicity-associated threat was related to increased MetS prevalence only among individuals of Central American background. Differential patterns of association between perceived discrimination and MetS components were found for different background groups. CONCLUSIONS: Overall results suggested that perceived discrimination was not strongly or consistently associated with MetS among Hispanics/Latinos.


Assuntos
Doenças Cardiovasculares/psicologia , Hispano-Americanos/psicologia , Síndrome Metabólica/psicologia , Discriminação Social/psicologia , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , América Central/etnologia , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etnologia , Pessoa de Meia-Idade , Percepção , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Circunferência da Cintura , Adulto Jovem
14.
Nutrients ; 11(6)2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31212683

RESUMO

This study examines the effects of educational text messages on diabetes self-care activities, cardiovascular disease (CVD) risk awareness, and home food availabilities related to food choices among patients with type 2 diabetes. Quasi-experimental design was used with 40 patients (58.0 ± 10.6 years) in the intervention group and 39 (55.7 ± 12.2 years) in the control group. In addition to the usual care provided for all participants, the intervention group received three educational text messages weekly for 12 weeks. Pre- and post-intervention measures were collected for both groups. Ninety-four percent of the participants receiving text messages indicated the usefulness of this program. The intervention group either maintained the same level or demonstrated small improvements in diabetes self-care activities after the intervention. Significant increases in scores of CVD risk awareness (57% increase; p = 0.04) and availabilities of fresh fruits (320% increase; p = 0.01) and fresh vegetables (250% increase; p = 0.02) in the home and weekly total (16% increase; p = 0.02) and moderate/vigorous (80% increase; p = 0.006) physical activity levels were observed for the intervention group relative to the control group. The pilot results suggest the feasibility and usefulness of the text message program for diabetes education. The study is registered with Clinical Trials.gov (NCT03039569).


Assuntos
Doenças Cardiovasculares/psicologia , Diabetes Mellitus Tipo 2/psicologia , Preferências Alimentares/psicologia , Educação de Pacientes como Assunto/métodos , Autocuidado/psicologia , Idoso , Conscientização , Doenças Cardiovasculares/etiologia , Telefone Celular , Diabetes Mellitus Tipo 2/complicações , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto , Projetos Piloto , Fatores de Risco , Autocuidado/métodos , Mensagem de Texto
15.
Medicine (Baltimore) ; 98(18): e15188, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045761

RESUMO

While it is important to treat lifestyle-related diseases for the primary and secondary prevention of cardiovascular diseases, medication adherence is still poor. Although various causes of poor adherence have been reported, the differences between physicians and their patients regarding the recognition of medication adherence have not been well-investigated.We administered a questionnaire about medication adherence to 300 outpatients and their 23 cardiologists at the Department of Cardiology, Fukuoka University Hospital. The questionnaires for patients and physicians included acceptable total number of drug doses and dosing schedule, forgetting to take the medicine, and dose-reduction or -increase based on self-judgement. The patients were 70.6 ±â€Š12.3 years old and 61.0% (n = 183) were male. Patients reported that it was acceptable to receive 0-5 doses twice daily. The patients were divided into two groups: an agreement group, in which physicians and their patients had the same answer to the question regarding forgetting medication (203 cases; 67.7%), and a disagreement group (97 cases; 32.3%). Overall, the inter-rater agreement between physicians and patients with regard to forgetting medication was significant, but slight (κ coefficient = 0.12). In a multivariate analysis, absence of hypertension [odds ratio (OR): 0.21, 95% confidence interval (CI): 0.09-0.50, P < .001), ß-blocker usage (OR: 1.86, 95% CI: 1.11-3.12, P = .02), and biguanide usage (OR: 4.04, 95% CI: 1.43-11.41, P = .01) were independent predictors of disagreement with regard to forgetting medication.The inter-rater agreement between physicians and patients with regard to medication adherence was slight. An increase in inter-rater agreement should improve medication adherence.


Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Hipertensão/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Relações Médico-Paciente/ética , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/psicologia , Feminino , Humanos , Hipertensão/psicologia , Japão/epidemiologia , Estilo de Vida , Masculino , Adesão à Medicação/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prevenção Secundária , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários
16.
Afr J Prim Health Care Fam Med ; 11(1): e1-e15, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-31038332

RESUMO

BACKGROUND:  Cardiovascular disease (CVD)-related deaths in sub-Saharan Africa (SSA) are on the rise, and primary care physicians could facilitate the reversal of this trend through treatment and prevention strategies. AIM:  The aim of this study was to determine the relationship between physician lifestyle practices, CVD prevention knowledge and patient CVD counselling practices among family physicians (FPs) and family medicine (FM) trainees affiliated to FM colleges and organisations in SSA. SETTING:  FPs and FM trainees affiliated to FM colleges and organisations in Anglophone SSA. METHODS:  A web-based cross-sectional analytical study was conducted using validated, self-administered questionnaires. Following collation of responses, the relationship between the participants' CVD prevention knowledge, lifestyle practices and CVD counselling rates was assessed. RESULTS:  Of the 174 participants (53% response rate), 83% were married, 51% were females and the mean age was 39.2 (standard deviation [SD] 7.6) years. Most of the participants responded accurately to the CVD prevention knowledge items, but few had accurate responses on prioritising care by 10-year risk. Most participants had less than optimal lifestyle practices except for smoking, vegetable or fruit ingestion and sleep habits. Most participants (65%) usually counselled patients on nutrition, but less frequently on weight management, exercise, smoking and alcohol. The region of practice and physicians with poor lifestyle were predictive of patient counselling rates. CONCLUSION:  Training on patient counselling and self-awareness for CVD prevention may influence patient counselling practice. Promoting quality training on patient counselling among FPs as well as a healthy self-awareness for CVD prevention is thus needed. The complex relationship between physician lifestyle and patient counselling warrants further study.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Aconselhamento/estatística & dados numéricos , Medicina de Família e Comunidade/estatística & dados numéricos , Corpo Clínico Hospitalar/psicologia , Médicos de Família/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Adulto , África ao Sul do Saara , Doenças Cardiovasculares/psicologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Médicos de Família/educação , Inquéritos e Questionários
17.
Kardiol Pol ; 77(5): 535-540, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31066730

RESUMO

BACKGROUND: Psychosocial risk factors for cardiovascular disease (CVD) are known to cluster in individuals, but the effect of cumulative exposure has not been thoroughly described in terms of CVD risk. AIMS: The aim of the study was to assess the relationship between accumulation of psychosocial risk factors such as low education, material deprivation, depressive symptoms, and low perceived control and the risk of incident CVD. METHODS: This cohort study with 11­year follow­up included a random population sample (age, 45-69 years). Psychosocial factors were assessed using standard tools. Accumulation of psychosocial risk factors was determined by summing up the number of psychosocial factors experienced. The risk of incident CVD depending on the number of psychosocial factors was estimated (reference, no psychosocial factors). Cox proportional hazards models were fitted. RESULTS: In total, 43 572 and 51 772 person­years were analyzed. There were 479 and 291 new CVD cases in men and women, respectively. An age­adjusted model showed an increase in CVD risk in men exposed to 3 and 4 psychosocial risk factors by nearly 60% and 125%, respectively (P <0.05). Further adjustment waved the association in individual strata, but a significant linear trend was observed. In women, in a fully adjusted model, the second and subsequent risk factors increased the risk of CVD by nearly 70% up to over 2­fold (P <0.001). The total population attributable risk associated with exposure to psychosocial risk factors in women was 34.1%. CONCLUSIONS: The accumulation of psychosocial risk factors was associated with increased risk of CVD. In men, the relation was substantially explained by classic risk factors. In women, about one-third of incident CVD cases could be attributed to psychosocial risk factors.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Idoso , Doenças Cardiovasculares/etiologia , Estudos de Coortes , Depressão , Educação , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
18.
PLoS One ; 14(5): e0217247, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31125371

RESUMO

BACKGROUND: Understanding of how cardiovascular risk information influence individuals is critical for the practice of risk assessment and the management of patients with cardiovascular disease. OBJECTIVES: The objective of this study was to investigate change in mental distress among research participants after undergoing a cardiovascular risk assessment and receiving individual test results. METHODS: In 2017, a questionnaire measuring mental distress after taking part in a risk assessment was distributed among 615 participants in the Swedish Cardiopulmonary Bio Image Study in Uppsala, Sweden, aged 50-64 years. Outcome measures were re-assessed after three months (30% were lost to follow-up). RESULTS: There were no differences in outcomes after three months for participants with normal test results or for participants who were referred to primary health care. Mental distress increased in participants who were referred to the hospital, and were further explained by the fact that these participants were diagnosed with coronary artery stenosis. CONCLUSIONS: CV risk information can be provided to individuals with lower levels of risk without concerns of inducing mental distress. However, in order to prevent unnecessary worry in contexts similar to this study, one should be prepared for different risk outcomes and plan for support for individuals with higher risk. The increased utility of powerful, yet not fully mature, imaging techniques requires careful considerations extending beyond medical risks and benefits; the clinician must also take into account the risk of mental distress and secure support when necessary.


Assuntos
Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/psicologia , Estresse Psicológico/complicações , Ansiedade/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Fatores de Risco , Suécia
19.
Complement Ther Med ; 44: 123-128, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31126544

RESUMO

OBJECTIVE: To examine and compare the demographic, health behavior, and cardiometabolic risk factor characteristics of participants who report 1) participating in yoga, 2) not participating yoga, or 3) are inactive, using a nationally representative sample of U.S. adults. DESIGN: Study participants were from the 1999-2006 National Health and Nutrition Examination Survey (NHANES) who self-reported participation in yoga (n = 74), no-yoga (n = 3,753) or were inactive (n = 1,285). Participants in the no-yoga group did engage in other types of physical activity, while the inactive group reported no activity during the survey period. RESULTS: Yoga participants were primarily female (80.7%), college educated (51.9%), mostly non-smokers (46.9%), and reported moderate alcohol consumption (72.1%). Yoga participants were found to be significantly less likely to have an elevated waist circumference (OR = 0.40, p < 0.01; OR = 0.30, p < 0.01), and a low HDL (OR = 0.43, p = 0.03; OR = 0.34, p < 0.05) compared to both non-yoga participants and inactive individuals, respectively. Yoga participants were 61% less likely to have elevated blood glucose compared to non-yoga participants (OR = 0.39, p < 0.05). Compared to inactive individuals, yoga participants were 52% (OR = 0.48, p < 0.05) and 66% (OR = 0.34, p < 0.05) less likely have an elevated body mass index and have elevated triglyceride levels, respectively. CONCLUSIONS: Given the emergence of yoga as a common form of physical activity, it is imperative to understand the characteristics of those who participate in yoga to further understand its relationship with cardiovascular risk. This study was one of the first to use nationally-representative data and objectively measured cardiometabolic variables. Key Words: complementary medicine, epidemiology, survey, population, physical activity, cardiovascular disease.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Comportamentos Relacionados com a Saúde/fisiologia , Ioga/psicologia , Adulto , Glicemia/fisiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/psicologia , HDL-Colesterol/sangue , Exercício/fisiologia , Exercício/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais/métodos , Fatores de Risco , Autorrelato , Inquéritos e Questionários , Triglicerídeos/sangue , Circunferência da Cintura/fisiologia
20.
Ter Arkh ; 91(1): 13-18, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-31090365

RESUMO

AIM: The aim of the study was to determine the impact of stress on work on the risk of cardiovascular disease over a 16-year period in an open population of 25-64 years in Russia/Siberia. MATERIALS AND METHODS: A random representative sample of the population of both sexes of 25-64 years old in Novosibirsk in 1994 (men: n=657, 44.3±0.4 years, response - 82.1%, women: n=689, 45.4±0.4 years, response - 72.5%). The screening survey program included: registration of socio-demographic data, determination of stress at work (Karazek scale). The period of prospective follow-up of participants was 16 years. The study identified the following "end points": the first cases of myocardial infarction (MI), stroke. RESULTS: A high level of stress at work was in 29.5% of men and 31.6% of women, the average level in 48.9% of men and 50.7% of women (χ2=2.574, υ=2, p=0.276). The risk of developing MI for a 16-year period, among people experiencing stressful situations at work, was: in men, HR=3.592, and women HR=3.218 (95% CI 1.146-9.042); stroke risk - among men, HR=2.603 (95% CI 1.06-4.153) in women HR=1.956 (95% CI 1.008-3.795). In multivariate analysis, in men with stress at work, the risk of MI among men was HR=1.15 (95% CI 0.6-2.2), among women - HR=2.543 (95% CI 1.88-7.351); risk of stroke, was in men, HR=3.8 (95% CI 1.6-8.8), in women - HR=1.95 (95% CI 0.984-3.887). The risk of stroke was higher among single, divorced and widowed men, HR=4.2 (95% CI 1.5-13.2), and in women with secondary or primary education, HR=3 (95% CI 0.852-11.039). CONCLUSION: It was established that a high level of stress at work is not gender-specific; the risk of developing MI over a 16-year period is higher in women than in men, stroke in men; the risk of myocardial infarction and stroke in both sexes is affected by the social gradient.


Assuntos
Doenças Cardiovasculares , Estresse Psicológico , Acidente Vascular Cerebral , Local de Trabalho , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Federação Russa/epidemiologia , Sibéria
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA