Cardiovascular disease

Cardiovascular diseases, diabetes mellitus, and cancer in the occupied Palestinian territory

by Abdullatif Husseini

Undiagnosed sleep apnoea syndrome in patients with acute myocardial infarction: potential importance of the STOP-BANG screening tool for clinical practice

by francesca cormack

Homocysteine, lipid indices and antioxidants in patients with ischaemic heart disease from Maharashtra, India

by Vinod Bhagwat

Exercise intervention and inflammatory markers in coronary artery disease: a meta-analysis

by Walter Swardfager

Swardfager W, Herrmann N, Cornish S, Mazereeuw G, Marzolini S, Sham L, Lanctôt KL. Am Heart J 2012;163:666-676.e3

Background: Inflammatory activity plays a role in the development and progression of coronary artery disease (CAD),... more Background: Inflammatory activity plays a role in the development and progression of coronary artery disease (CAD), and exercise confers survival benefit. We performed a meta-analysis of changes in inflammatory biomarkers over the course of exercise interventions in patients with CAD.

Methods: We searched MEDLINE, Embase, the Cochrane Collaboration, AMED, and CINAHL for studies reporting peripheral inflammatory biomarker concentrations before and after exercise interventions of ≥2 weeks in patients with CAD. Data were summarized using standard mean differences (SMD) and 95% CIs.

Results: Twenty-three studies were included. Concentrations of C-reactive protein (CRP; SMD −0.345, 95% CI −0.444 to −0.246, n = 1,466, P < .001), interleukin 6 (SMD −0.546, 95% CI −0.739 to −0.353, n = 280, P < .001), fibrinogen (SMD −0.638, 95% CI −0.953 to −0.323, n = 247, P < .001), and vascular cell adhesion molecule 1 (SMD −0.413, 95% CI −0.778 to −0.048, n = 187, P = .027) were lower postintervention. Higher total cholesterol (B = −0.328, 95% CI −0.612 to −0.043, P = .026) and higher total/high-density lipoprotein cholesterol ratios (B = −0.250, 95% CI −0.425 to −0.076, P = .008) at baseline were associated with greater reductions in CRP. In controlled studies, follow-up concentrations of CRP (SMD −0.500, 95% CI −0.844 to −0.157, nexercise/control = 485/284, P = .004), and fibrinogen (SMD −0.544, 95% CI −1.058 to −0.030, nexercise/control = 148/100, P = .038) were lower in subjects who exercised compared with controls.

Conclusion: Exercise training is associated with reduced inflammatory activity in patients with CAD. C-reactive protein and fibrinogen have provided the strongest evidence. Higher baseline CRP and adverse baseline lipid profiles predicted greater reductions in CRP.

Identification of protein disulfide isomerase as a cardiomyocyte survival factor in isichemic cardiomyopathy

by Gabriele Toietta

Anna Severino, Mara Campioni, Stefania Straino, Fadi N Salloum, Nina Schmidt, Ulrike Herbrand, Stilla Frede, Gabriele Toietta, Giuliana Di Rocco, Rossana Bussani, Furio Silvestri, Maddalena Piro, Giovanna Liuzzo, Luigi M Biasucci, Pasquale Mellone, Florinda Feroce, Maurizio Capogrossi, Feliciano Baldi, Joachim Fandrey, Michael Ehrmann, Filippo Crea, Antonio Abbate, Alfonso Baldi
J Am Coll Cardiol. (2007) 50(11):1029-37.

Punjabi Sikh Patients’ Perceived Barriers to Engaging in Physical Exercise Following Myocardial Infarction

by Paul Galdas

Galdas, P.M. Oliffe, J.L. Kang, H.B.K., Kelly, M.T.

Objective
The aim of this research was to describe Punjabi Sikh patients’ perceived barriers to engaging in... more Objective
The aim of this research was to describe Punjabi Sikh patients’ perceived barriers to engaging in physical exercise following myocardial infarction (MI).

Design and Sample
A qualitative, interpretive descriptive methodology was used. The sample included 15 Punjabi Sikh patients who were attending a cardiac rehabilitation education program in an urban center of British Columbia, Canada, following MI.

Measurements
Data were collected via semi-structured interviews and were audio recorded, translated from Punjabi to English, and transcribed verbatim. Data were analyzed using an interpretive thematic approach that involved a process of coding and constant comparison.

Results
Four key factors emerged that related to participants’ perceived barriers to sustained engagement in physical activity: (1) difficulty in determining safe exertion levels independently; (2) fatigue and weakness; (3) preference for ‘informal’ exercise; and (4) migration-related challenges.

Conclusions
The findings have implications for the design and delivery of health promotion strategies aimed at Punjabi Sikh patients’ post-MI that is contingent on the use of ‘formal’ exercise settings to promote regular physical activity. The willingness among Punjabi Sikh patients to practise brisk walking offers a positive direction that public health nurses and other healthcare professionals may want to capitalize on in the delivery of exercise-related health promotion.

Sleep disturbance is associated with cardiovascular and metabolic disorders

by Michael Grandner

Existing research has demonstrated associations between sleep duration and obesity, diabetes, cardiovascular disease... more Existing research has demonstrated associations between sleep duration and obesity, diabetes, cardiovascular disease and mortality. Sleep disorders research has shown that sleep apnoea, insomnia and other sleep disorders confer risk for cardiometabolic disease, particularly in the presence of reduced sleep duration. The aim of the present study was to examine the associations between general sleep disturbance, operationalized as 'difficulty falling asleep, staying asleep, or sleeping too much' as measured in a large, nationally representative sample, and self-reported history of myocardial infarction, stroke, coronary artery disease, diabetes and obesity. Data from the Behavioral Risk Factor Surveillance System were analysed. Complete data were available for 138 201 individuals. A hierarchical logistic regression analysis examined associations before and after adjustment for demographic, socioeconomic, medical and psychological factors. After adjusting for demographic, socioeconomic and health risk factors, sleep duration was associated with obesity [odds ratio (OR) = 1.18, P < 0.0005), diabetes (OR = 1.18, P < 0.005), myocardial infarction (OR = 1.36, P < 0.0005), stroke (OR = 1.22, P < 0.05) and coronary artery disease (OR = 1.59, P < 0.0005). In fully adjusted models that included physical health, significant relationships remained for obesity (OR = 1.14, P < 0.0005), myocardial infarction (OR = 1.23, P < 0.005) and coronary artery disease (OR = 1.43, P < 0.0005). Sleep disturbance is a significant risk factor for obesity, diabetes, myocardial infarction, stroke and coronary artery disease, and effects for obesity, myocardial infarction and coronary artery disease are the most robust after adjustment. This study demonstrates that sleep disturbance is a novel risk factor that is potentially modifiable. Future research should determine whether sleep intervention could reduce the cardiometabolic consequences of sleep disturbance.

Evidence for a cognitive bias of interpretation toward threat in individuals with a Type D personality

by Delphine Grynberg

Grynberg, D., Gidron, Y., Denollet, J., & Luminet, O. (2011)

Biological and behavioral mediators link Type D personality with a poor prognosis in heart disease. However, the... more Biological and behavioral mediators link Type D personality with a poor prognosis in heart disease. However, the mediator role of cognitive biases is still unknown. This study tested whether Type D individuals exhibit an interpretative bias for ambiguous social situations. For this aim we examined Type D and non-Type D individuals’ evaluations of written social situations that varied in terms of situations’ clarity (clear, ambiguous) and social judgment (neutral, negative). A convenience sample of 42 young, healthy adults rated each situation in relation to the difficulty of formulating a verbal response, anticipated distress, and perceived threat, and they completed the Type D personality scale (DS14; Denollet, 2005). Results showed an interpretation bias among Type D individuals, as they rated ambiguous or neutral situations as significantly more distressing compared to non-Type D individuals. Only clearly negative situations were rated similarly by Type D and non-Type D individuals. The discussion suggests that this interpretation bias in Type D individuals would increase their vulnerability to perceived stress.

Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III)

by Frank Doyle

Vanhees et al, European Journal of Preventive Cardiology (formerly European Journal of Cardiovascular Prevention & Rehabilitation)

Recommendations from the European Association of Cardiovascular Prevention and Rehabilitation

The beneficial effect of exercise training and exercise-based cardiac rehabilitation on symptom-free exercise... more The beneficial effect of exercise training and exercise-based cardiac rehabilitation on symptom-free exercise capacity, cardiovascular and skeletal muscle function, quality of life, general healthy lifestyle, and reduction of depressive symptoms and psychosocial stress is nowadays well recognized. However, it remains largely obscure, which characteristics of physical activity (PA) and exercise training − frequency, intensity, time (duration), type (mode), and volume (dose: intensity × duration) of exercise – are the most effective. The present paper, therefore, will deal with these exercise characteristics in the management of individuals with cardiovascular disease, i.e. coronary artery disease and chronic heart failure patients, but also in patients with congenital or valvular heart disease. Based on the current literature, and if sufficient evidence is available, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding frequency, intensity, time and type of PA, and safety aspects during exercise in patients with cardiovascular disease. This paper is the third in a series of three papers, all devoted to the same theme: the importance of the exercise characteristics in the management of cardiovascular health. Part I is directed to the general population and Part II to individuals with cardiovascular risk factors. In general, PA recommendations and exercise training programmes for patients with coronary artery disease or chronic heart failure need to be tailored to the individual’s exercise capacity and risk profile, with the aim to reach and maintain the individually highest fitness level possible and to perform endurance exercise training 30–60 min daily (3–5 days per week) in combination with resistance training 2–3 times a week. Because of the frequently reported dose–response relationship between training effect and exercise intensity, one should seek sufficiently high training intensities, although more scientific evidence on effect sizes and safety is warranted. At present, there is insufficient data to give more specific recommendations on type, dosage, and intensity of exercise in some other cardiovascular diseases, such as congenital heart disease, valve disease, cardiomyopathies, channelopathies, and patients with implanted devices.

Importance of characteristics and modalities of physical activity and exercise in defining the benefits to cardiovascular health within the general population: recommendations from the EACPR (Part I)

by Frank Doyle

Vanhees et al, European Journal of Preventive Cardiology (formerly European Journal of Cardiovascular Prevention & Rehabilitation)

Recommendations from the European Association of Cardiovascular Prevention and Rehabilitation

Over the last decades, more and more evidence is accumulated that physical activity (PA) and exercise interventions... more Over the last decades, more and more evidence is accumulated that physical activity (PA) and exercise interventions are essential components in primary and secondary prevention for cardiovascular disease. However, it is less clear whether and which type of PA and exercise intervention (aerobic exercise, dynamic resistive exercise, or both) or characteristic of exercise (frequency, intensity, time or duration, and volume) would yield more benefit in achieving cardiovascular health. The present paper, as the first of a series of three, will make specific recommendations on the importance of these characteristics for cardiovascular health in the population at large. The guidance offered in this series of papers is aimed at medical doctors, health practitioners, kinesiologists, physiotherapists and exercise physiologists, politicians, public health policy makers, and the individual member of the public. Based on previous and the current literature, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding type, volume, and intensity of PA and exercise.

Is Heart Rate Variability Reduced in Depression Without Cardiovascular Disease?

by Daniel Quintana

Prospective study of circulating soluble CD40 ligand concentrations and the incidence of cardiovascular disease in a nested prospective case-control study of older men and women.

by Barbara Jefferis

Jefferis BJ, Whincup PH, Welsh P, Wannamethee SG, Rumley A, Lawlor DA, Ebrahim S, Lowe GD.
SourceDepartment of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London, UK. b.jefferis@ucl.ac.uk

J Thromb Haemost. 2011 Aug;9(8):1452-9. doi: 10.1111/j.1538-7836.2011.04415.x.


Abstract more J Thromb Haemost. 2011 Aug;9(8):1452-9. doi: 10.1111/j.1538-7836.2011.04415.x.


Abstract
BACKGROUND: CD40 ligand(CD40L) is implicated in atherosclerotic plaque formation.

OBJECTIVES: We investigated prospective associations between circulating soluble CD40L and myocardial infraction (MI) or stroke in an older general population cohort, accounting for established and novel cardiovascular risk factors.

METHODS: Baseline serum CD40L (sCD40L) was measured in incident MI (n = 368) and stroke (n = 304) cases and two controls per case, 'nested' in prospective UK studies of 4252 men and 4286 women aged 60-79 years, sampled from general practices in Britain in 1998-2000, with 7-year follow-up for fatal and non-fatal MI and stroke.

RESULTS: sCD40L was higher in smokers and negatively associated with lung function and positively associated with total cholesterol and markers of inflammation, but not with other established cardiovascular disease (CVD) risk factors. Geometric mean sCD40L levels did not differ between MI cases and controls (5.94 ng mL(-1) vs. 5.82 ng mL(-1); P = 0.5) or between stroke cases and controls (5.61 ng mL(-1) vs. 5.28 ng mL(-1), P = 0.1). There was no strong evidence for elevated risk of MI or stroke in multivariable models comparing participants in the top to those in the bottom third of sCD40L. Age-adjusted odds ratios (ORs) were 1.39 [95% confidence interval (CI) 0.98, 1.96] for MI and 1.16 (0.78, 1.73) for stroke. These attenuated to 1.24 (95% CI 0.86, 1.79) and 1.18 (0.78, 1.78), respectively, after adjustment for established and novel CVD risk factors.

CONCLUSIONS: sCD40L is associated with other inflammatory markers but is not itself a strong independent risk marker for either stroke or MI.

© 2011 International Society on Thrombosis and Haemostasis.

PMID:21696538[PubMed - in process]

Keywords: CD40, coronary heart disease, epidemiology, myocardial infarction, prospective study, stroke.

Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II)

by Frank Doyle

Vanhees et al, European Journal of Preventive Cardiology (formerly European Journal of Cardiovascular Prevention & Rehabilitation)

Recommendations from the European Association of Cardiovascular Prevention and Rehabilitation

In a previous paper, as the first of a series of three on the importance of characteristics and modalities of physical... more In a previous paper, as the first of a series of three on the importance of characteristics and modalities of physical activity (PA) and exercise in the management of cardiovascular health within the general population, we concluded that, in the population at large, PA and aerobic exercise capacity clearly are inversely associated with increased cardiovascular disease risk and all-cause and cardiovascular mortality and that a dose–response curve on cardiovascular outcome has been demonstrated in most studies. More and more evidence is accumulated that engaging in regular PA and exercise interventions are essential components for reducing the severity of cardiovascular risk factors, such as obesity and abdominal fat, high BP, metabolic risk factors, and systemic inflammation. However, it is less clear whether and which type of PA and exercise intervention (aerobic exercise, dynamic resistive exercise, or both) or characteristic of exercise (frequency, intensity, time or duration, and volume) would yield more benefit for each separate risk factor. The present paper, therefore, will review and make recommendations for PA and exercise training in the management of cardiovascular health in individuals with cardiovascular risk factors. The guidance offered in this series of papers is aimed at medical doctors, health practitioners, kinesiologists, physiotherapists and exercise physiologists, politicians, public health policy makers, and individual members of the public. Based on previous and the current literature overviews, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding type, volume, and intensity of PA and regarding appropriate risk evaluation during exercise in individuals with cardiovascular risk factors.

Disturbed dreaming in medical conditions (2004)

by Tore Nielsen

Prevalence of the metabolic syndrome in patients with chronic low back pain comparing several definitions of the metabolic syndrome

by Juliane Hardt

Hardt J, Vödisch K, Raspe H. [Prevalence of the metabolic syndrome in patients with chronic low back pain comparing several definitions of the metabolic syndrome].[Abstract in German]. Gesundheitswesen 2010; 72. DOI: 10.1055/s-0030-1266736

Poster with data can be provided on demand.

Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies

by David Wormser

Platelet response to low-dose enteric-coated aspirin in patients with stable cardiovascular disease

by Ronan Conroy

ANTITHROMBOTIC EFFECT, A NOT WELL KNOWN CHARACTERISTIC OF FRUITS AND VEGETABLES

by Constanza Torres-Urrutia

Antioxidant effect of fruits and vegetables of central region of Chile

by Constanza Torres-Urrutia

Platelet antiaggregants: mechanisms of action and use asocied risks

by Constanza Torres-Urrutia