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Lifestyle behaviours in patients with established cardiovascular diseases: a European observational study.

ABSTRACT: BACKGROUND:Patients who have experienced a cardiovascular clinical event such as a myocardial infarction or stroke qualify for intensive risk factor evaluation and management. The aim of this study is to explore lifestyle changes as well as the achievement of targets for risk factors in patients with established cardiovascular disease. METHODS:Cross-sectional study conducted in primary care practices. The study was carried out in six European countries (Croatia, France, Portugal, Slovenia, Spain and Turkey). Patients with established cardiovascular disease (coronary heart disease and stroke) attended in primary care were selected and assessed from January to June 2016. Patients were recruited and assessed at the practice by research assistants between 6 months and 3 years after the event. Statistical comparisons were done with the unpaired two-sided Student's t-test for continuous variables and Chi-square test for categorical variables. RESULTS:Nine hundred and seventy-three patients (32.4% females) were assessed. About 14% of them were smokers, 32% were physically inactive, and 30% had nutritionally poor eating behaviours. LDL cholesterol target value below 70?mg/dl was achieved in about 23% of patients, and in general, women were less cardio-protected by drugs than men. CONCLUSIONS:Many patients with established cardiovascular disease who attended in general practice still fail to achieve the lifestyle, risk factor, and therapeutic targets set by European guidelines. These results are relevant to general practitioners because these patients have a high risk of subsequent cardiovascular events, including MI, stroke, and death.

SUBMITTER: Fernandez D

PROVIDER: S-EPMC6878626 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Lifestyle behaviours in patients with established cardiovascular diseases: a European observational study.

Fernández Diana D Brotons Carlos C Moral Irene I Bulc Mateja M Afonso Mélanie M Akan Hülya H Pinto Susana S Vucak Jasna J da Silva Martins Carlos Manuel CM

BMC family practice 20191126 1

<h4>Background</h4>Patients who have experienced a cardiovascular clinical event such as a myocardial infarction or stroke qualify for intensive risk factor evaluation and management. The aim of this study is to explore lifestyle changes as well as the achievement of targets for risk factors in patients with established cardiovascular disease.<h4>Methods</h4>Cross-sectional study conducted in primary care practices. The study was carried out in six European countries (Croatia, France, Portugal, ...[more]

PMID: 31771525

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Project description:BackgroundHealthy lifestyle behaviours are effective means to reduce the burden of diseases. This study was aimed to fill the knowledge gaps on the distribution, associated factors, and potential health benefits on mortality of four healthy lifestyle behaviours in China.MethodsDuring 2015-2019, participants aged 35-75 years from 31 provinces were recruited by the China PEACE Million Persons Project. Four healthy lifestyle behaviours were investigated in our study, including non-smoking, none or moderate alcohol use, sufficient leisure time physical activity (LTPA), and healthy diet.ResultsAmong 903,499 participants, 74.1% were non-smokers, 96.0% had none or moderate alcohol use, 23.6% had sufficient LTPA, 11.1% had healthy diet, and only 2.8% had all the four healthy lifestyle behaviours. The adherence varied across seven regions; the highest median of county-level adherence to all the four healthy lifestyle behaviours was in North China (3.3%) while the lowest in the Southwest (0.8%) (p < 0.05). Participants who were female, elder, non-farmers, urban residents, with higher income or education, hypertensive or diabetic, or with a cardiovascular disease (CVD) history were more likely to adhere to all the four healthy lifestyle behaviours (p < 0.001). County-level per capital Gross Domestic Product (GDP) was positively associated with sufficient LTPA (p < 0.05 for both rural and urban areas) and healthy diet (p < 0.01 for urban areas), while negatively associated with none or moderate alcohol use (p < 0.01 for rural areas). Average annual temperature was negatively associated with none or moderate alcohol use (p < 0.05 for rural areas) and healthy diet (p < 0.001 for rural areas). Those adhering to all the four healthy lifestyle behaviours had lower risks of all-cause mortality (HR 0.64 [95% CI: 0.52, 0.79]) and cardiovascular mortality (HR 0.53 [0.37, 0.76]) after a median follow-up of 2.4 years.ConclusionsAdherence to healthy lifestyle behaviours in China was far from ideal. Targeted health promotion strategies were urgently needed.

Project description:BACKGROUND: The extent to which patients follow treatments as prescribed is pivotal to treatment success. An exceptionally high level (> 95%) of HIV medication adherence is required to suppress viral replication and protect the immune system and a similarly high level (> 80%) of adherence has also been suggested in order to benefit from prescribed exercise programmes. However, in clinical practice, adherence to both often falls below the desirable level. This project aims to investigate a wide range of psychological and personality factors that may lead to adherence/non-adherence to medical treatment and exercise programmes. METHODS: HIV positive patients who are referred to the physiotherapist-led 10-week exercise programme as part of the standard care are continuously recruited. Data on social cognitive variables (attitude, intention, subjective norms, self-efficacy, and outcome beliefs) about the goal and specific behaviours, selected personality factors, perceived quality of life, physical activity, self-reported adherence and physical assessment are collected at baseline, at the end of the exercise programme and again 3 months later. The project incorporates objective measures of both exercise (attendance log and improvement in physical measures such as improved fitness level, weight loss, improved circumferential anthropometric measures) and medication adherence (verified by non-invasive hair analysis). DISCUSSION: The novelty of this project comes from two key aspects, complemented with objective information on exercise and medication adherence. The project assesses beliefs about both the underlying goal such as following prescribed treatment; and about the specific behaviours such as undertaking the exercise or taking the medication, using both implicit and explicit assessments of patients' beliefs and attitudes. We predict that i) the way people think about the underlying goal of their treatments explains medication and exercise behaviours over and above the effects of the behaviour-specific thinking and ii) the relationship between adherence to exercise and to medical treatment is stronger among those with more favourable views about the goal. Results from this study should identify the key contributing factors to inform subsequent adherence research and afford a more streamlined assessment matrix. The project also aims to inform patient care practices. UK CLINICAL RESEARCH NETWORK REGISTRATION NUMBER: UKCRN 7842.

Project description:BackgroundAdherence to a combination of healthy lifestyle factors has been related to a considerable reduction of cardiovascular risk in white populations; however, little is known whether such associations persist in nonwhite populations like the Asian population.ObjectivesThis study aimed to examine the associations of a combination of modifiable, healthy lifestyle factors with the risks of ischemic cardiovascular diseases and estimate the proportion of diseases that could potentially be prevented by adherence to these healthy lifestyle patterns.MethodsThis study examined the associations of 6 lifestyle factors with ischemic heart disease and ischemic stroke (IS) in the China Kadoorie Biobank of 461,211 participants 30 to 79 years of age who did not have cardiovascular diseases, cancer, or diabetes at baseline. Low-risk lifestyle factors were defined as nonsmoking status or having stopped smoking for reasons other than illness, alcohol consumption of <30 g/day, a median or higher level of physical activity, a diet rich in vegetables and fruits and limited in red meat, a body mass index of 18.5 to 23.9 kg/m2, and a waist-to-hip ratio <0.90 for men and <0.85 for women.ResultsDuring a median of 7.2 years (3.3 million person-years) of follow-up, this study documented 3,331 incident major coronary events (MCE) and 19,348 incident ISs. In multivariable-adjusted analyses, current nonsmoking status, light to moderate alcohol consumption, high physical activity, a diet rich in vegetables and fruits and limited in red meat, and low adiposity were independently associated with reduced risks of MCE and IS. Compared with participants without any low-risk factors, the hazard ratio for participants with ≥4 low-risk factors was 0.42 (95% confidence interval: 0.34 to 0.52) for MCE and 0.61 (95% confidence interval: 0.56 to 0.66) for IS. Approximately 67.9% (95% confidence interval: 46.5% to 81.9%) of the MCE and 39.1% (95% confidence interval: 26.4% to 50.4%) of the IS cases were attributable to poor adherence to healthy lifestyle.ConclusionsAdherence to healthy lifestyle may substantially lower the burden of cardiovascular diseases in Chinese.

Project description:BACKGROUND: Nurses have an increased risk for non-communicable diseases (NCDs), along with a high prevalence of obesity, poor eating habits and insufficient physical activity. The aim of this study was to determine the health concerns, health priorities and barriers to living a healthy lifestyle among nurses and hospital management staff from public hospitals in the Western Cape Metropole, South Africa. METHODS: Participants were purposively sampled (n?=?103), and included management personnel (n?=?9), night shift (n?=?57) and day-shift nurses (n?=?36). Twelve focus groups (FGDs) were conducted with nursing staff to obtain insight into nurses' health concerns, lifestyle behaviours and worksite health promotion programmes (WHPPs). Seven key informant interviews (KII) were conducted with management personnel, to gain their perspective on health promotion in the worksite. Thematic analysis was used to analyse the data with the assistance of Atlas.ti Qualitative Data Analysis Software. RESULTS: Night shift nurses frequently identified weight gain and living with NCDs such as hypertension as their main health concerns. Being overweight was perceived to have a negative impact on work performance. All nurses identified backache and exposure to tuberculosis (TB) as occupation-related health concerns, and both management and nurses frequently reported a stressful working environment. Nurses frequently mentioned lack of time to prepare healthy meals due to long working hours and being overtired from work. The hospital environment was perceived to have a negative influence on the nurses' lifestyle behaviours, including food service that offered predominantly unhealthy foods. The most commonly delivered WHPPs included independent counselling services, an online employee wellness programme offered by the Department of Health and wellness days in which clinical measures, such as blood glucose were measured. Nurses identified a preference for WHPPs that provided access to fitness facilities or support groups. CONCLUSIONS: Public hospitals are a stressful work environment and shift work places an additional strain on nurses. The risk of NCDs and exposure to infectious disease remains a concern in this working population. Our findings highlight the need for WHPPs that support nurses in managing stress and transforming the work environment to facilitate healthy lifestyles.

Project description:IntroductionIn heart transplant recipients (HTRs), non-adherence (NA) to immunosuppressive (IS) medication and to recommended lifestyle behaviours are a common phenomenon and associated with higher risk of allograft rejection, organ loss and mortality. Risk factors for NA are highly diverse and still insufficiently researched. Precise measures of NA and an accurate understanding of its aetiology are of undisputable importance to detect patients at risk and intervene accordingly. The aim of this study is to assess the accuracy and concordance of different measures for NA as well as to determine potential risk factors.Methods and analysisThis is a single-centre prospective observational trial. HTRs who are at least aged 18 are no less than 6 months post-transplant and receive tacrolimus (Prograf or Advagraf), cyclosporine (Sandimmun) or everolimus (Certican) as their prescribed IS medication are eligible for participation. We only include patients during the phase of medication implementation. At study enrolment, we assess depression, health-related quality of life, self-efficacy, social support, attachment, experiences and attitudes towards IS medication, emotional responses after transplantation, satisfaction with information about IS medication and perceptions and beliefs about medications. We further ask patients to rate their lifestyle behaviours concerning alcohol, smoking, diet, physical activity, sun protection and appointment keeping via questionnaires. Three different measurement methods for NA are applied at T0: self-reports, physician's estimates and IS trough levels. NA is monitored prospectively using an electronic multicompartment pillbox (MEMS, VAICA) over a 3-month period. Meanwhile, participants receive phone calls every second week to obtain additional self-reports, resulting in a total of seven measurement points.Ethics and disseminationThe study was approved by the Clinical Ethics Committee of the University Hospital Erlangen (Friedrich-Alexander-University, Erlangen-Nürnberg). Written informed consent is attained from all participants. The results of this study will be published in peer-reviewed journals and presented at conferences.Trial registration numberDRKS00020496.

Project description:In this exploratory study we examined the associations between several social network characteristics and lifestyle behaviours in adults at increased risk of diabetes and cardiovascular diseases. In addition, we explored whether similarities in lifestyle between individuals and their network members, or the level of social support perceived by these individuals, could explain these associations.From the control group of the Hoorn Prevention Study, participants with high and low educational attainment were approached for a structured interview between April and August 2010. Inclusion was stopped when fifty adults agreed to participate. Participants and a selection of their network members (e.g. spouses, best friends, neighbours, colleagues) completed a questionnaire on healthy lifestyle that included questions on fruit and vegetable intake, daily physical activity and leisure-time sedentary behaviour. We first examined associations between network characteristics and lifestyle using regression analyses. Second, we assessed associations between network characteristics and social support, social support and lifestyle, and compared the participants' lifestyles to those of their network members using concordance correlation coefficients.Fifty adults (50/83 x 100 = 62% response) and 170 of their network members (170/192 x 100 = 89% response) participated in the study. Individuals with more close-knit relationships, more friends who live nearby, and a larger and denser network showed higher levels of vegetable consumption and physical activity, and lower levels of sedentary behaviour. Perceived social norms or perceived support for behavioural change were not related to healthy lifestyle. Except for spousal concordance for vegetable intake, the lifestyle of individuals and their network members were not alike.Study results suggest that adults with a larger and denser social network have a healthier lifestyle. Underlying mechanisms for these associations should be further explored, as the current results suggest a minimal role for social support and modelling by network members.

Dataset Information

Lifestyle behaviours in patients with established cardiovascular diseases: a European observational study.

Publications

Lifestyle behaviours in patients with established cardiovascular diseases: a European observational study.

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