Healthy lifestyles and personal responsibility

Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis

The present meta-analysis was conducted to compare the safety and efficacy of angiontensin receptor neprilysin inhibitor (ARNI) with angiotensin receptor blockers (ARBs) and angiotensin-converting-enzyme inhibitors (ACEi) in patients with heart failure with reduced ejection fraction (HFrEF). This meta-analysis was conducted and reported in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Two authors carried out a scientific literature search on online databases, including EMBASE, PubMed, and the Cochrane Library. The following keywords or corresponding Medical Subject Headings (MeSH) were used for the search of relevant articles: "heart failure with reduced ejection fraction," "angiotensin receptor-neprilysin inhibitor," "Angiotensin receptor blockers," and "clinical outcomes." Outcomes assessed in the present meta-analysis included changes in ejection fraction (EF) from baseline in percentage. Other outcomes assessed in the present meta-analysis included all-cause mortality, cardiovascular death, and hospitalization due to heart failure. Adverse events assessed in the present meta-analysis included hypokalemia, acute kidney injury, and hypotension. Total 10 studies were included. This meta-analysis showed that treatment with ARNI was associated with a significantly lower risk of all-cause mortality and cardiovascular death compared to control groups. There was no significant difference between the two groups in terms of change of EF from baseline or hospitalization related to heart failure. However, the risk of hypotension was significantly higher in patients receiving ARNI. The study findings support the use of ARNI as first-line therapy for heart failure with reduced ejection fraction. Further studies are required to determine the optimal use of ARNI in heart failure management and to investigate the mechanisms underlying the increased risk of hypotension.

Lifestyle and Pain in Women With Knee Osteoarthritis

Osteoarthritis (OA) is the main cause of pain and disability in the elderly. The disease leads to chronic musculoskeletal pain, characterized by an abnormal excitability of pain conduction pathways, and lifestyle may interfere in this pathophysiological aspect. Thus, the aim of this study was to compare perceived pain, pressure pain threshold, and lifestyle of adult and elderly women with and without knee OA. A total of 143 women were recruited and divided into 2 groups: OA (n = 68) and control (n = 75). Volunteers were evaluated for pressure pain tolerance (algometry in vastus medialis and vastus lateralis muscles), perceived pain (visual analogue scale) and lifestyle (FANTASTIC questionnaire). Patients with OA of the present study presented higher weight (P = .001) and body mass index (P < .001) than controls. Results also revealed less tolerance to pressure pain (P < .001) and higher pain perception (P < .001) in patients with OA. OA group scored significantly lower in lifestyle questionnaire than controls (P = .03). Patients with OA in the present study who presented lifestyle scores below median presented significantly higher values of pain perception than the ones above it (P = .03). In conclusion, patients with OA present more sensitivity to pain, more perceived pain, and worse lifestyle than healthy individuals.

Health Promoting Lifestyle Behaviors in Menopausal Women: A Cross-Sectional Study

BACKGROUND

Determining health promoting lifestyle behaviors of age-specific groups of women provides valuable information for designing health promotion intervention programs. Hence the present study was conducted to assess health promoting lifestyle behaviors in menopausal women.

METHODS

The present descriptive cross-sectional study examined health promoting lifestyle behaviors in 400 menopausal women admitted to health care centers in Neka city-north of Iran-from March 2015 to July 2015. Health promoting lifestyle behaviors were evaluated using a demographic characteristics form and the Health Promoting Lifestyle Profile II (HPLP II) through simple convenience sampling. Data were analyzed in SPSS version 18 using descriptive and inferential statistics at the significance level of P<0.05.

RESULTS

The mean score of participants' health promoting lifestyle behaviors was 136.43±19.61, ranging from 88 to 194. The logistic regression test revealed women's health promoting lifestyle behaviors to be significantly related to their place of residence (P=0.009, odds ratio=1.73) and their spouse's level of education (P=0.027, odds ratio=0.58). The Pearson correlation test showed significant relationships between mean score of the six sub-scale of health promoting lifestyle behaviors with each other (P<0.001).

CONCLUSION

These findings have implications for addressing the role of men to promote health promoting lifestyle behaviors among rural menopausal women.