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1.
[Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors].
Kang, SH, Hwang, SY
Journal of Korean Academy of Nursing. 2019;(6):748-759
Abstract
PURPOSE This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers. METHODS A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email. RESULTS After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention. CONCLUSION To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.
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2.
Supervised training in primary care units but not self-directed physical activity lowered cardiovascular risk in Brazilian low-income patients: a controlled trial.
Lima, AM, Werneck, AO, Cyrino, E, Farinatti, P
BMC public health. 2019;(1):1738
Abstract
BACKGROUND Public health strategies to increase physical activity in low-income communities may reduce cardiovascular risk in these populations. This controlled trial compared the cardiovascular risk estimated by the Framingham Risk Score (FRS) over 12 months in formally active (FA), declared active (DA), and physically inactive (PI) patients attended by the 'Family Health Strategy' in low-income communities at Rio de Janeiro City, Brazil (known as 'favelas'). METHODS Patients were matched for age and assigned into three groups: a) FA (supervised training, n = 53; 60.5 ± 7.7 yrs); b) DA (self-reported, n = 43; 57.0 ± 11.2 yrs); c) PI (n = 48; 57.0 ± 10.7 yrs). FA performed twice a week a 50-min exercise circuit including strength and aerobic exercises, complemented with 30-min brisk walking on the third day, whereas DA declared to perform self-directed physical activity twice a week. Comparisons were adjusted by sex, chronological age, body mass index, and use of anti-hypertensive/statin medications. RESULTS At baseline, groups were similar in regards to body mass, body mass index, triglycerides, and LDL-C, as well to FRS and most of its components (age, blood pressure, hypertension prevalence, smoking, HDL-C, and total cholesterol; P > 0.05). However, diabetes prevalence was 10-15% lower in DA vs. FA and PI (P < 0.05). Intention-to-treat analysis showed significant reductions after intervention (P < 0.05) in FA for total cholesterol (~ 10%), LDL-C (~ 15%), triglycerides (~ 10%), systolic blood pressure (~ 8%), and diastolic blood pressure (~ 9%). In DA, only LDL-C decreased (~ 10%, P < 0.05). Significant increases were found in PI (P < 0.05) for total cholesterol (~ 15%), LDL-C (~ 12%), triglycerides (~ 15%), and systolic blood pressure (~ 5%). FRS lowered 35% in FA (intention-to-treat, P < 0.05), remained stable in DA (P > 0.05), and increased by 20% in PI (P < 0.05). CONCLUSIONS A supervised multi-modal exercise training developed at primary care health units reduced the cardiovascular risk in adults living in very low-income communities. The risk remained stable in patients practicing self-directed physical activity and increased among individuals who remained physically inactive. These promising results should be considered within public health strategies to prevent cardiovascular disease in communities with limited resources. TRIAL REGISTRATION TCTR20181221002 (retrospectively registered). Registered December 21, 2018.
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3.
Impact of pharmacist's intervention on reducing cardiovascular risk in obese patients.
Huete, L, Manzano-Lista, FJ, Aránguez, I, Fernández-Alfonso, MS
International journal of clinical pharmacy. 2019;(4):1099-1109
Abstract
Background Obesity is a risk factor for cardiovascular disease, the leading cause of death. Health education, nutritional follow-up, and life style habits modification are key for cardiovascular risk reduction in obese patients. Objective To measure the impact of pharmacist's intervention on cardiovascular risk in obese patients. Setting A Spanish community pharmacy. Method Obese patients (BMI ≥ 30) with (group A, n = 30) and without (group B, n = 14) comorbidities were selected. Variables determined in first visit on-site: anthropometric values (weight, height, waist circumference), blood pressure, glycemic (glucose, HbA1c) and lipid parameters (total cholesterol, HDL-c, LDL-c, triglycerides). The PharmaFit Protocol consisted in a 24-month follow-up focusing (i) monthly on adherence to nutritional guidelines and modification of life style habits, and (ii) bi-monthly on anthropometric variables, blood pressure, and biochemical determinations. Feedback was provided to the primary care physician or specialist. Main ouitcome measure Cardiovascular risk estimated by REGICOR score. Results Anthropometric variables significantly decreased in all groups. Plasma glucose levels were significantly reduced in group A without changes in HbA1c. Lipid parameters significantly improved in group A, whereas HDL-c significantly raised in all groups. REGICOR score was significantly reduced in group A female (13.8 ± 1.6 vs. 5.8 ± 1, p < 0.0001) and male (12.7 ± 1.7 vs. 4.4. ± 0.6, p < 0.005) patients, and in group B female patients (3.5 ± 0.7 vs. 1.9 ± 0.4, p < 0.001). Conclusion Community pharmacist intervention, delivered as a 24-month follow-up and combining health and dietary education, has a highly positive impact on the reduction of cardiovascular risk in obese patients.
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The effect of a two-year school-based daily physical activity intervention on a clustered CVD risk factor score-The Sogndal school-intervention study.
Resaland, GK, Aadland, E, Nilsen, AKO, Bartholomew, JB, Andersen, LB, Anderssen, SA
Scandinavian journal of medicine & science in sports. 2018;(3):1027-1035
Abstract
To evaluate changes in clustered cardiovascular disease (CVD) risk factors in 9-year-old children following a 2-year school-based physical activity intervention. In total, 259 children (age 9.3 ± 0.3 years) were invited, of whom 256 participated. The intervention group (63 boys, 62 girls) carried out 60-minute teacher-controlled daily physical activity over two school years. The control group (62 boys, 69 girls) had the curriculum-defined amount of physical education (45 minutes twice each week). Of these, 67% (171 total, 91 intervention) successfully completed both baseline and post-intervention of six CVD risk factors: systolic blood pressure (SBP), triglyceride (TG), total cholesterol-to-high-density lipoprotein cholesterol ratio (TC:HDL ratio), waist circumference (WC), the homeostasis model assessment for insulin resistance (HOMA), and peak oxygen uptake (VO2peak ). All variables were standardized by sex prior to constructing a cluster score (sum of z scores for all variables). The effect of the intervention on the cluster score was analyzed using linear multiple regression. The cluster score improved after the intervention (ES = .29). Furthermore, the analyses showed significant effects in favor of the intervention group for systolic blood pressure (ES = .35), total cholesterol-to-HDL-c ratio (ES = .23), triglyceride (ES = .40), and VO2peak (ES = .57). A teacher-led school-based physical activity intervention that is sufficiently long and includes a substantial amount of daily physical activity can beneficially modify children's clustered CVD risk profile.
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5.
Effects of recombinant human growth hormone administration on cardiovascular risk factors in obese children with relative growth hormone deficiency.
Liang, S, Xue, J, Li, G
Lipids in health and disease. 2018;(1):66
Abstract
BACKGROUND Based on the sample of obese children with relative growth hormone deficiency (GHD), the objective of our study was to determine the effects of rhGH treatment on cardiovascular risk factors, including body mass index (BMI), lipid levels and glucose metabolism index. METHODS A total of 43 obese children with relative GHD were included in our final analysis. The obese subjects were divided into two groups: recombinant human growth hormone (rhGH) treatment group and untreated control group. RESULTS After 6 months, subjects in the rhGH treatment group had significant reductions in BMI standard deviation scores (SDS) compared with controls (2.32 ± 0.85 vs. 2.80 ± 0.61; P = 0.041), and Insulin-like growth factor 1(IGF-1) level increased during rhGH treatment, in comparison with the control group (702.91 ± 246.03 vs. 348.30 ± 131.93 ng/mL, P < 0.001). GH treatment reduced low density lipoprotein cholesterol (LDL-C) (2.20 ± 0.45 vs. 2.63 ± 0.76 mmol/L, P = 0.027), aspartate aminotransferase (AST) (21.26 ± 5.72 vs. 32.30 ± 17.68 mmol/L, P = 0.006) as well as alanine aminotransferase (ALT) (16.70 ± 6.72 vs. 45.20 ± 46.62 mmol/L, P = 0.002), and increased high density lipoprotein cholesterol (HDL-C) (1.45 ± 0.40 vs. 1.19 ± 0.23 mmol/L, P = 0.016) levels compared with the control group. CONCLUSION RhGH treatment for 6 months on obese children with relative GHD reduces BMI SDS, stabilize IGF-1 levels, and exerts beneficial effects on blood lipid profiles and live enzyme compared with untreated control group. Moreover, GH administration has no significant effects on increased insulin resistance and no adversely effect on glucose homeostasis.
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Normalization of cardiovascular risk factors in peri-menopausal women with Pycnogenol®.
Luzzi, R, Belcaro, G, Hosoi, M, Feragalli, B, Cornelli, U, Dugall, M, Ledda, A
Minerva ginecologica. 2017;(1):29-34
Abstract
BACKGROUND The aim of the study was the evaluation of the efficacy of Pycnogenol® in peri-menopausal women in controlling homocysteine and C-reactive protein (CRP) levels, borderline cardiovascular risk factors, oxidative stress (OS) and symptoms associated to menopausal transition (MT). METHODS Pycnogenol®, 100mg/day, was used as a supplement for 8 weeks by a group of 35 women. A comparable group of 35 women with identical cardiovascular risk factors was included as the control group. All women were instructed to participate in a best management plan of menopause. RESULTS The two groups were comparable. All women completed the eight weeks study. Only minor deviations from the best management plan were observed. At inclusion, both groups were similar in respect to risk factors. Supplementation with Pycnogenol® decreased the slightly elevated cholesterol and triglycerides after 8 weeks (P<0.05). Also the fasting glucose levels were normalized (P<0.05). The borderline increased blood pressure was reduced to normal values at 8 weeks (P<0.05). Plasma free radicals dropped significantly by 22% (P<0.05). Homocysteine and CRP levels decreased sharply by 43% and 60%, respectively (P<0.05). No significant changes of these risk factors were noted in the control group. Almost all menopausal symptoms, scored by The Menopausal Symptoms Questionnaire 34, improved significantly following supplementation with Pycnogenol®. The supplementation was well tolerated. CONCLUSIONS The supplementation with Pycnogenol® improved the quality of life of perimenopausal women and normalized a series of cardiovascular risk factors, especially factors connected to cardiovascular events, as homocysteine and CRP.
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[New possibilities of pharmacotherapy in cardiovascular patients with mental disorders].
Medvedev, VE, Frolova, VI, Epifanov, AV
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2014;(9):30-7
Abstract
OBJECTIVE To study the efficacy and tolerability of the drugs pantogam active and phenotropil in mild neurotic, somatoform, stress-induced and depressive disorders developed in patients with cardiovascular diseases. MATERIAL AND METHODS The effect of pantogam active was assessed in an open study. The main group of patients (n=35) treated with phenotropil during 12 weeks was compared to the comparison group (n=35). Patient's status was evaluated using psychometric (CGI, HDRS etc) and adverse effect scales. RESULTS AND СONCLUSION Statistically significant results demonstrated the advantages of pantogam active has advantage on a number of values. The treatment effect of pantogam active gradually increased while the effect (in particular anxiolytic one) of phenotropil decreased after 4-8 weeks of treatment. The tolerability of both drugs was satisfactory.
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8.
[Development and evaluation of a small group-based cardiocerebrovascular disease prevention education program for male bus drivers].
Kim, EY, Hwang, SY
Journal of Korean Academy of Nursing. 2012;(3):322-32
Abstract
PURPOSE This study was conducted to examine effects of a small group-based cardiocerebrovascular disease (CVD) prevention education program on knowledge, stage of change and health behavior among male bus drivers with CVD risk factors. METHODS A non-equivalent control group pretest-posttest design was used. Participants were 68 male bus drivers recruited from two urban bus companies. Participants from the two groups were selected by matching age, education and risk factors. Experimental group (n=34) received a small group-based CVD prevention education program 8 times over 6 weeks and 3 times through telephone interviews at 2-week intervals. Data were collected between December, 2010 and March, 2011, and were analyzed using chi-square test, t-test, and repeated measure analysis of variance with SPSS/Win18.0. RESULTS Experimental group showed significantly higher scores in CVD prevention knowledge (p<.001) and health behavior (p<.001) at 6 and 12 weeks after intervention. Participants in pre-contemplation and contemplation stages made progress to contemplation and action. This was significantly better at 6 and 12 weeks after intervention (p<.001). CONCLUSION Results suggest that small group-based education programs for CVD prevention are effective in increasing knowledge, stage of change, and health behavior to prevent CVD among male bus drivers with CVD risk.
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Dietitian-coached management in combination with annual endocrinologist follow up improves global metabolic and cardiovascular health in diabetic participants after 24 months.
Battista, MC, Labonté, M, Ménard, J, Jean-Denis, F, Houde, G, Ardilouze, JL, Perron, P
Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2012;(4):610-20
Abstract
This 24 month study evaluated the effect of dietitian coaching combined with minimal endocrinologist follow up on the glycemic control and cardiovascular risks of diabetic participants, compared with conventional endocrinologist follow up. Participants with type 1 or type 2 diabetes were assigned to either the control group with conventional endocrinologist follow up (C; n = 50) or the dietitian-coached group (DC; n = 51) with on-site diabetes self-management education every 3 months combined with annual endocrinologist followup. Over the 24 month intervention, weight (-0.7 vs. +2.1 kg; p = 0.04), BMI (+0.3 vs. +0.7 kg/m(2); p = 0.009), and waist circumference (-1.3 vs. +2.4 cm; p = 0.01) significantly differed between the DC and control groups. HbA(1C) dropped significantly in participants of the DC versus the control group (-0.6% vs.-0.3%; p = 0.04). This was accompanied by improved overall energy intake (-548 vs. -74 kcal/day; p = 0.04). However, no link associated glycemic control to nutrient intake or intensiveness of pharmacotherapy. Coaching by a dietitian improves glycemic control and reduces certain cardiovascular risk factors in diabetic subjects, demonstrating that a joint dietitian-endocrinologist model of care provides a convenient strategy for cardiovascular risk management in the diabetic population.
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10.
Cardiovascular risk assessment with oxidised LDL measurement in postmenopausal women receiving intranasal estrogen replacement therapy.
Kurdoglu, M, Yildirim, M, Kurdoglu, Z, Erdem, A, Erdem, M, Bilgihan, A, Goktas, B
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2011;(8):551-7
Abstract
OBJECTIVE To investigate the effect of intranasal estrogen replacement therapy administered to postmenopausal women alone or in combination with progesterone on markers of cardiovascular risk. METHODS The study was conducted with 44 voluntary postmenopausal women. In group I (n = 15), the patients were treated with only intranasal estradiol (300 μg/day estradiol hemihydrate). In group II (n = 11), the patients received cyclic progesterone (200 mg/day micronized progesterone) for 12 days in each cycle in addition to continuous intranasal estradiol. Group III (n = 18) was the controls. Serum lipid profiles, oxidised low-density lipoprotein (LDL) and other markers of cardiovascular risk were assessed at baseline and at the 3rd month of the treatment. RESULTS Lipid profile, LDL apolipoprotein B, lipoprotein a, homocysteine, oxidised LDL values and oxidised LDL/LDL cholesterol ratio were not observed to change after 3 months compared to baseline values within each group (p > 0.016). In comparison to changes between the groups after the treatment, only oxidised LDL levels and oxidised LDL/LDL cholesterol ratios of group II were increased compared to control group (p < 0.05). CONCLUSIONS Intranasal estradiol alone did not appear to have an effect on markers of cardiovascular risk in healthy postmenopausal women. However, the addition of cyclic oral micronized progesterone to intranasal estradiol influenced the markers of cardiovascular risk negatively in comparison to non-users in healthy postmenopausal women.