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Garcia-Silva J, Borrego IRS, Navarrete NN, Peralta-Ramirez MI, Águila FJ, Caballo VE. Efficacy of cognitive-behavioural therapy for lifestyle modification in metabolic syndrome: a randomised controlled trial with a 18-months follow-up. Psychol Health 2024; 39:195-215. [PMID: 35345950 DOI: 10.1080/08870446.2022.2055023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To test the efficacy of cognitive-behavioural therapy (CBT) for lifestyle modification in patients with metabolic syndrome (MetS). DESIGN 76 MetS patients completed this clinical trial, with 18 months follow-up. 45 participants from the experimental group (EG - CBT) and 31 to the control group (CG - usual care). The CBT programme was performed by a psychologist in a face-to-face group format, during 12 weekly sessions lasting 90 minutes. The intervention for the CG consisted of workshops with basic information about MetS and it's associated cardiovascular risk. MAIN OUTCOME MEASURES Efficacy of (CBT) in (MetS) patients. RESULTS Results showed reduction in weight (mean difference - MD -2.633, 95%CI [-4.322, -0.943]; p<.003), waist circumference (MD -2.944, 95%CI [-5.090, -0.798]; p<.008), body mass index (MD -0.915, 95%CI [-1.494, -0.335]; p<.003), systolic (MD -0.046, 95%CI [-0.685, -0.023]; p<.0002) diastolic blood pressure (MD -4.777, 95%CI [-7.750, -1.804]; p<.002), and cardiovascular risk score after 18 months. An increase in adherence to the Mediterranean diet and assertiveness and a reduction in anger were observed in EG. The CG did not show any significant differences. CONCLUSION The CBT focused on changes in lifestyle seems to be effective in the reduction of MetS and cardiovascular risk factors. TRIAL REGISTRATION Registered at clinicaltrials.gov (NCT02949622) - PROMETS (Multimodal Intervention Program for Patients with Metabolic Syndrome).
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Affiliation(s)
- Jaqueline Garcia-Silva
- Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
| | | | - Nuria Navarrete Navarrete
- Clinical Management Unit, Department of Internal Medicine, University Hospital Complex of Granada, Granada, Spain
| | - María Isabel Peralta-Ramirez
- Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
- CIMCYC: Centre for Mind, Brain and Behavioural Research, University of Granada, Granada, Spain
| | - Fernando Jaén Águila
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, University Hospital Complex of Granada, Granada, Spain
| | - Vicente E Caballo
- Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
- CIMCYC: Centre for Mind, Brain and Behavioural Research, University of Granada, Granada, Spain
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[Obesity - A Risk Factor for Psoriasis and COVID-19]. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:489-494. [PMID: 34629472 PMCID: PMC7977150 DOI: 10.1016/j.ad.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 12/13/2020] [Indexed: 12/16/2022] Open
Abstract
Obesity is a major health problem whose well-known association with psoriasis has been amply described. The importance of obesity as a risk factor for poor prognosis in the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 infection has recently been demonstrated. This review examines a possible relationship between obesity, psoriasis, and COVID-19, analyzing the pathophysiological links and their practical implications. On the one hand, a higher body mass index increases the risk of psoriasis and is also a factor in metabolic syndrome, which is common in patients with psoriasis and has been implicated in reducing the effectiveness of psoriasis treatments. On the other hand, obesity is a risk factor for severe COVID-19 and mortality. Obesity also promotes a proinflammatory state in the lung, where it compromises respiratory mechanics.
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Llamas-Velasco M, Ovejero-Merino E, Salgado-Boquete L. Obesity - A Risk Factor for Psoriasis and COVID-19. ACTAS DERMO-SIFILIOGRAFICAS 2021. [PMID: 34629472 PMCID: PMC7977150 DOI: 10.1016/j.adengl.2021.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Obesity is a major health problem whose well-known association with psoriasis has been amply described. The importance of obesity as a risk factor for poor prognosis in the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 infection has recently been demonstrated. This review examines a possible relationship between obesity, psoriasis, and COVID-19, analyzing the pathophysiological links and their practical implications. On the one hand, a higher body mass index increases the risk of psoriasis and is also a factor in metabolic syndrome, which is common in patients with psoriasis and has been implicated in reducing the effectiveness of psoriasis treatments. On the other hand, obesity is a risk factor for severe COVID-19 and mortality. Obesity also promotes a proinflammatory state in the lung, where it compromises respiratory mechanics.
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Affiliation(s)
- M Llamas-Velasco
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, Spain
| | - E Ovejero-Merino
- Servicio de Cirugía General y Digestiva, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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Del Pozo-Valero R, Martín-Oterino JÁ, Rodríguez-Barbero A. Influence of elevated sleep-time blood pressure on vascular risk and hypertension-mediated organ damage. Chronobiol Int 2020; 38:367-377. [PMID: 33100058 DOI: 10.1080/07420528.2020.1835944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report the analysis of 252 hypertensive patients whose blood pressure (BP) was assessed by around-the-clock ambulatory BP monitoring compared to office BP measurement during a follow-up investigation of 8.7 y (SD: 2.43 y) that evaluated the added value of measuring sleep-time BP values. We found that 37.3% of the patients had mismatched diagnoses between the two techniques of BP assessment, with 11.5% of the patients showing white-coat hypertension and 25.8% masked hypertension. Only 12.3% of the diagnosed and treated patients presented normal BP values. Nocturnal (sleep-time) hypertension was present in 70.63%. The sleep-time systolic BP mean was found to be an independent vascular risk factor (F = 9.005, p < .001), indirectly measured through the 10-year risk of morbidity and mortality. Additionally, the elevated sleep-time systolic BP mean was a better marker of subclinical hypertension-mediated organ damage (ρ = 0.19, p < .01) than either the awake (ρ = 0.168, p < .01) or 24 (ρ = 0.184, p < .01) systolic BP means. In conclusion, the accuracy and sleep-time measurements provided by ambulatory BP make it particularly relevant in hypertension diagnosis and management. The use of the ambulatory BP measurement method could end up modifying current therapeutic targets, with sleep-time systolic BP mean becoming a main one, in order to optimize hypertension control and reduce hypertension-related organ pathology and cardiovascular disease morbidity and mortality.
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Affiliation(s)
- Raquel Del Pozo-Valero
- Group of Vascular Endothelium Pathophysiology, Department of Physiology and Pharmacology, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - José Ángel Martín-Oterino
- Department of Internal Medicine, University Hospital of Salamanca, Faculty of Medicine, University of Salamanca and Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Alicia Rodríguez-Barbero
- Group of Vascular Endothelium Pathophysiology, Department of Physiology and Pharmacology, Faculty of Medicine, University of Salamanca, and Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
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Díaz Vera AS, Abellán Alemán J, Segura Fragoso A, Martínez de Esteban JP, Lameiro Couso FJ, Golac Rabanal MDS, Díaz Vera LA, Matta Solis HH. The prevalence and risk factors associated with dyslipidemia in type 2 diabetic patients in the autonomous Region of Cantabria. ACTA ACUST UNITED AC 2019; 67:102-112. [PMID: 31235401 DOI: 10.1016/j.endinu.2019.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Dyslipidemia is one of the main risk factors in cardiovascular disease in patients with diabetes mellitus type 2 (DM2). The aim of this study is to evaluate the prevalence and risk factors associated with dyslipidemia in the population with diabetes mellitus type 2 in the region of Cantabria. MATERIAL AND METHODS This is a transversal study carried out at Cantabrian primary health care centres (n=680). A representative, random sample of the population with DM2, ranging from 18-85, was selected using a multistage procedure. The medical records were obtained, and by means of interviews the data of the risk factors to be studied was secured. The correlation with dyslipidemia was analysed by means of logistic regression. RESULTS There were 52.1% of males, the average age was 69.8, the evolution of diabetes was 9.99 years, 84.3% had arterial hypertension, 76.6% were overweight or obese and the average HbA1c was 6.96%. The prevalence of dyslipidemia was 85.3%, and in the bivariate analysis this is associated with a history of peripheral artery disease, controlled diabetes, antihypertensive treatment, glomerular filtration, HbA1c>7%, body fat estimated as being either overweight or obese, a history of cardiovascular disease, age and HbA1c. In the multivariate analysis the independent factors were being female and a history of cardiovascular disease. CONCLUSION The prevalence of dyslipidemia in our study was 85.3%, and is consistent with figures found in previous published studies. The independent associated risk factors were being female and a past medical history of cardiovascular disease.
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Affiliation(s)
| | - José Abellán Alemán
- Cátedra de Riesgo Cardiovascular, Universidad Católica San Antonio de Murcia, Murcia, España
| | - Antonio Segura Fragoso
- Servicio de Investigación, Instituto de Ciencias de la Salud, Universidad de Castilla-La Mancha, Talavera de la Reina (Toledo), España
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Arija V, Villalobos F, Pedret R, Vinuesa A, Jovani D, Pascual G, Basora J. Physical activity, cardiovascular health, quality of life and blood pressure control in hypertensive subjects: randomized clinical trial. Health Qual Life Outcomes 2018; 16:184. [PMID: 30217193 PMCID: PMC6137925 DOI: 10.1186/s12955-018-1008-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/03/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Physical activity (PA) promotes cardiovascular health and health related quality of life (HRQoL), although the effect of that on blood pressure (BP) control has rarely been studied in hypertensive subjects. Our aim was to evaluate the effectiveness of a PA intervention programme on cardiovascular disease (CVD) risk, HRQoL and BP control in hypertensive subjects. METHODS A randomized clinical trial, with a PA intervention programme of 9 months duration, comprising a walking group of 120 min/week, supervised, and with socio-cultural activities. Participants were 207 hypertensive subjects (68.2 years, 76.8% women). PA (IPAQ-s), diet, CVD risk, BP, BMI, smoking, and HRQoL (SF-36) were assessed at baseline and at the end of the intervention. Changes in CVD risk and in HRQoL during the intervention was calculated (end-baseline score). Multivariate models were applied. RESULTS In multivariate models, the PA intervention programme, with no modification of the diet, decreased CVD risk (- 1.19 points) and the systolic BP (- 8.68 mmHg), and increased some areas of HRQoL (4.45 to 14.62 points). An increase in the percentage of subjects with controlled BP was observed by the PA programme itself (OR 5.395 to 5.785 according to multivariate models), and by the changes during the intervention in the decrease in CVD risk (OR 0.609) and in the increase in the HRQoL in physical component summary (OR 1.041), role physical (OR 1.010), and bodily pain (OR 1.014), independently of controlled BP at baseline. CONCLUSIONS This PA intervention programme improved cardiovascular health and HRQoL, and favoured BP control in primary care users with hypertension. TRIAL REGISTRATION Clinicaltrials.gov ID NCT02767739 ; Trial registered on May 5th, 2016. Retrospectively registered.
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Affiliation(s)
- Victoria Arija
- Unitat Suport a la Recerca Reus-Tarragona, Institut d'Investigació en Atenció Primária, IDIAP Jordi Gol (Barcelona), Camí de Riudoms 57, 43202, Reus, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona, Spain.
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Tarragona, Spain.
| | - Felipe Villalobos
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Roser Pedret
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Angels Vinuesa
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Dolors Jovani
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Gabriel Pascual
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Josep Basora
- Unitat Suport a la Recerca Reus-Tarragona, Institut d'Investigació en Atenció Primária, IDIAP Jordi Gol (Barcelona), Camí de Riudoms 57, 43202, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona, Spain
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Tarragona, Spain
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
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