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Wan L, Yang G, Dong H, Liang X, He Y. Impact of cardiovascular disease on health-related quality of life among older adults in eastern China: evidence from a national cross-sectional survey. Front Public Health 2024; 11:1300404. [PMID: 38288433 PMCID: PMC10822954 DOI: 10.3389/fpubh.2023.1300404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/28/2023] [Indexed: 01/31/2024] Open
Abstract
Objective This study explores the health-related quality of life (HRQoL) scores of Chinese older adults with Cardiovascular Disease(CVD) using the EQ-5D-3L, the aim of this study is to investigate the association between health and HRQoL in older adults with CVD. Methods The data for this study were obtained from a cross-sectional study involving older adults residing in Chinese communities The EQ-5D-3L is used to measure the HRQoL scores in the older adults with CVD. One-way analyses were conducted using the Wilcoxon rank sum test and the Kruskal-Wallis H test to assess differences between groups. A binary logistic regression model was employed to analyze the influence each variable has on the presence of "any problem" on each dimension of EQ-5D-3L in older adults with CVD. An ordinal least squares (OLS) model is used to assess the relationship between older adults with CVD and HRQoL. Results The mean EQ-5D-3L score for older adults with CVD is 0.774. 40.0% of older adults with CVD reported problems with pain/discomfort, followed by Mobility (35.9%), Self-care (31.5%), and Anxiety/depression (17.0%). Binary logistic regression models show that financial resources were the main factor influencing the five dimensions of EQ-5D-3L. The OLS model further indicates that younger age, financial resources, and a lower number of chronic conditions among older adults with CVD are associated with higher HRQoL scores. Conclusion Chinese older adults with CVD have low HRQoL scores. Variousfactors influence both overall HRQoL scores and scores on each EQ-5D-3L dimension. This study is helpful in enhancing society's attention to the HRQoL of older adults with CVD and taking targeted measures to improve them.
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Affiliation(s)
- Leping Wan
- School of Management, Hainan Medical University, Hainan, China
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Guangmei Yang
- School of Management, Hainan Medical University, Hainan, China
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Haiying Dong
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Hainan, China
| | - Xiaoxiao Liang
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Hainan, China
| | - Yan He
- School of Management, Hainan Medical University, Hainan, China
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Shen R, Zou T. The association between cardiovascular health and depression: Results from the 2007-2020 NHANES. Psychiatry Res 2024; 331:115663. [PMID: 38064908 DOI: 10.1016/j.psychres.2023.115663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/02/2024]
Abstract
BACKGROUND Limited research has been conducted on the correlation between Life's Essential 8 (LE8), the recently updated algorithm for evaluating cardiovascular health (CVH), and depression. METHODS A total of 21,942 individuals were chosen from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2020. The depression was determined using the Patient Health Questionnaire (PHQ-9), with a score of 10 or higher indicating diagnosis. The LE8 score consists of 8 metrics: sleep health, diet, physical activity, nicotine exposure, body mass index, blood lipids, blood glucose, and blood pressure. Each LE8 metric was scored from 0 to 100 points. The summation of all metrics divided by 8 generated the total LE8 score and was categorized into low (0-49), moderate (50-79), and high (80-100) CVH. Weighted logistic regression and restricted cubic splines (RCS) were used to assess the association between LE8 score and depression. RESULTS A significant inversely nonlinear relationship was observed between LE8 score and depression. When compared to participants with high CVH, those with moderate CVH had multivariable adjusted odds ratios (ORs) for depression of 2.36 (95 % CI, 1.79-3.10), while those with low CVH had ORs of 4.71 (95 % CI, 3.44-6.47). Moreover, the effect size of the LE8 score on depression remained stable in all pre-specified subgroups, with all P-values for interaction being more than 0.05. CONCLUSIONS The results indicate a significant inversely nonlinear relationship between LE8 score and depression, particularly among males. These findings emphasize the importance of maintaining higher CVH as a preventive measure against depression.
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Affiliation(s)
- Ruihuan Shen
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, PR China
| | - Tong Zou
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, PR China.
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Patterson SL, Marcus M, Goetz M, Vaccarino V, Gooding HC. Depression and Anxiety Are Associated With Cardiovascular Health in Young Adults. J Am Heart Assoc 2022; 11:e027610. [PMID: 36533593 PMCID: PMC9798786 DOI: 10.1161/jaha.122.027610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Cardiovascular health (CVH) declines in young adulthood, and mood disorders commonly emerge during this life stage. This study examined the association between depression, anxiety, and CVH metrics among young adults. Methods and Results We conducted a cross-sectional analysis of participants aged 18 to 34 years who completed the Emory Healthy Aging Study Health History Questionnaire (n=875). We classified participants as having poor, intermediate, or ideal levels of the 8 CVH metrics using definitions set forth by the American Heart Association with adaptions when necessary. We defined depression and anxiety as absent, mild, or moderate to severe using standard cutoffs for Patient Health Questionnaire and General Anxiety Disorder scales. We used multivariable regression to examine the association between depression and anxiety and CVH, adjusting for age, sex, race and ethnicity, income, and education. The mean participant age was 28.3 years, and the majority identified as women (724; 82.7%); 129 (14.7%) participants had moderate to severe anxiety, and 128 (14.6%) participants had moderate to severe depression. Compared with those without anxiety, participants with moderate to severe anxiety were less likely to meet ideal levels of physical activity (adjusted prevalence ratio [aPR], 0.60 [95% CI, 0.44-0.82]), smoking (aPR, 0.90 [95% CI, 0.82-0.99]), and body mass index (aPR, 0.79 [95% CI, 0.66-0.95]). Participants with moderate to severe depression were less likely than those without depression to meet ideal levels of physical activity (aPR, 0.48 [95% CI, 0.34-0.69]), body mass index (aPR, 0.75 [95% CI, 0.61-0.91]), sleep (aPR, 0.79 [95% CI, 0.66-0.94]), and blood pressure (aPR, 0.92 [95% CI, 0.86-0.99]). Conclusions Anxiety and depression are associated with less ideal CVH in young adults. Interventions targeting CVH behaviors such as physical activity, diet, and sleep may improve both mood and CVH.
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Affiliation(s)
- Sierra L. Patterson
- Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillNC
| | - Michele Marcus
- Department of EpidemiologyRollins School of Public HealthAtlantaGA,Department of Environmental HealthRollins School of Public HealthAtlantaGA
| | | | - Viola Vaccarino
- Department of EpidemiologyRollins School of Public HealthAtlantaGA
| | - Holly C. Gooding
- Department of PediatricsEmory University School of MedicineAtlantaGAUnited States,Children’s Healthcare of AtlantaAtlantaGA
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Gaffey AE, Gathright EC, Fletcher LM, Goldstein CM. Screening for Psychological Distress and Risk of Cardiovascular Disease and Related Mortality: A SYSTEMATIZED REVIEW, META-ANALYSIS, AND CASE FOR PREVENTION. J Cardiopulm Rehabil Prev 2022; 42:404-415. [PMID: 36342683 PMCID: PMC9646240 DOI: 10.1097/hcr.0000000000000751] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Psychological distress-elevated symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), or psychosocial stress-has been associated with risk for cardiovascular disease (CVD). Despite increasing attention to the importance of these factors for CVD prevention, the state of this science requires updated synthesis to enable practice recommendations. Moreover, it is unknown whether psychological distress based on screeners, validated self-report instruments that efficiently identify those who may require mental health services or additional support, is associated with incident CVD. METHODS MEDLINE, Embase, and PsycInfo were searched for studies published 2017-2022, including adults without a past psychiatric diagnosis, who were screened at baseline for depression, anxiety, PTSD, stress, or general mental health symptoms, and followed for >6 mo to determine their risk for incident CVD (ie, atrial fibrillation, acute coronary syndrome, coronary heart disease, peripheral vascular disease, heart failure, or a composite). A meta-analysis was used to aggregate results to determine whether clinically significant levels of psychological distress were associated with CVD onset. RESULTS The search identified 28 investigations that represented 658 331 participants (58% women). Fifteen studies had adequate data for the primary meta-analysis, which indicated that those reporting high psychological distress showed a 28% greater risk of incident CVD compared with those with low or no distress. CONCLUSIONS Rapid screening for psychological distress is a helpful and efficient approach to understanding the CVD risk profile of an individual. Additional investigations are needed to improve prospective evidence concerning psychosocial stress. Conducting analyses by sex may better elucidate the benefits of psychological distress screening for men and women, respectively, and encourage more widespread adoption in CVD prevention.
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Affiliation(s)
- Allison E. Gaffey
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, West Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Emily C. Gathright
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | | | - Carly M. Goldstein
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Weight Control and Diabetes Research Center, Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University
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Shah RV, Miller P, Colangelo LA, Chernofsky A, Houstis NE, Malhotra R, Velagaleti RS, Jacobs DR, Gabriel KP, Reis JP, Lloyd‐Jones DM, Clish CB, Larson MG, Vasan RS, Murthy VL, Lewis GD, Nayor M. Blood-Based Fingerprint of Cardiorespiratory Fitness and Long-Term Health Outcomes in Young Adulthood. J Am Heart Assoc 2022; 11:e026670. [PMID: 36073631 PMCID: PMC9683648 DOI: 10.1161/jaha.122.026670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022]
Abstract
Background Cardiorespiratory fitness is a powerful predictor of health outcomes that is currently underused in primary prevention, especially in young adults. We sought to develop a blood-based biomarker of cardiorespiratory fitness that is easily translatable across populations. Methods and Results Maximal effort cardiopulmonary exercise testing for quantification of cardiorespiratory fitness (by peak oxygen uptake) and profiling of >200 metabolites at rest were performed in the FHS (Framingham Heart Study; 2016-2019). A metabolomic fitness score was derived/validated in the FHS and was associated with long-term outcomes in the younger CARDIA (Coronary Artery Risk Development in Young Adults) study. In the FHS (derivation, N=451; validation, N=914; age 54±8 years, 53% women, body mass index 27.7±5.3 kg/m2), we used LASSO (least absolute shrinkage and selection operator) regression to develop a multimetabolite score to predict peak oxygen uptake (correlation with peak oxygen uptake r=0.77 in derivation, 0.61 in validation; both P<0.0001). In a linear model including clinical risk factors, a ≈1-SD higher metabolomic fitness score had equivalent magnitude of association with peak oxygen uptake as a 9.2-year age increment. In the CARDIA study (N=2300, median follow-up 26.9 years, age 32±4 years, 44% women, 44% Black individuals), a 1-SD higher metabolomic fitness score was associated with a 44% lower risk for mortality (hazard ratio [HR], 0.56 [95% CI, 0.47-0.68]; P<0.0001) and 32% lower risk for cardiovascular disease (HR, 0.68 [95% CI, 0.55-0.84]; P=0.0003) in models adjusted for age, sex, and race, which remained robust with adjustment for clinical risk factors. Conclusions A blood-based biomarker of cardiorespiratory fitness largely independent of traditional risk factors is associated with long-term risk of cardiovascular disease and mortality in young adults.
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Affiliation(s)
- Ravi V. Shah
- Vanderbilt Translational and Clinical Research CenterCardiology DivisionVanderbilt University Medical CenterNashvilleTN
| | - Patricia Miller
- Department of BiostatisticsBoston University School of Public HealthBostonMA
| | - Laura A. Colangelo
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
| | - Ariel Chernofsky
- Department of BiostatisticsBoston University School of Public HealthBostonMA
| | - Nicholas E. Houstis
- Cardiology DivisionDepartment of MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMA
| | - Rajeev Malhotra
- Cardiology DivisionDepartment of MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMA
| | | | - David R. Jacobs
- Division of Epidemiology and Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMN
| | | | - Jared P. Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood InstituteBethesdaMD
| | - Donald M. Lloyd‐Jones
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | | | - Martin G. Larson
- Department of BiostatisticsBoston University School of Public HealthBostonMA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyFraminghamMA
| | - Ramachandran S. Vasan
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyFraminghamMA
- Sections of Cardiovascular Medicine and Preventive Medicine and EpidemiologyDepartment of MedicineBoston University School of MedicineBostonMA
- Department of EpidemiologyBoston University School of Public Health, and the Center for Computing and Data SciencesBoston UniversityBostonMA
| | - Venkatesh L. Murthy
- Department of EpidemiologyBoston University School of Public Health, and the Center for Computing and Data SciencesBoston UniversityBostonMA
- Division of Cardiovascular MedicineDepartment of Medicine, and Frankel Cardiovascular Center University of MichiganAnn ArborMI
| | - Gregory D. Lewis
- Cardiology DivisionDepartment of MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMA
- Pulmonary Critical Care UnitMassachusetts General HospitalBostonMA
| | - Matthew Nayor
- Sections of Cardiovascular Medicine and Preventive Medicine and EpidemiologyDepartment of MedicineBoston University School of MedicineBostonMA
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Lloyd-Jones DM, Ning H, Labarthe D, Brewer L, Sharma G, Rosamond W, Foraker RE, Black T, Grandner MA, Allen NB, Anderson C, Lavretsky H, Perak AM. Status of Cardiovascular Health in US Adults and Children Using the American Heart Association's New "Life's Essential 8" Metrics: Prevalence Estimates From the National Health and Nutrition Examination Survey (NHANES), 2013 Through 2018. Circulation 2022; 146:822-835. [PMID: 35766033 DOI: 10.1161/circulationaha.122.060911] [Citation(s) in RCA: 96] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The American Heart Association recently published an updated algorithm for quantifying cardiovascular health (CVH)-the Life's Essential 8 score. We quantified US levels of CVH using the new score. METHODS We included individuals ages 2 through 79 years (not pregnant or institutionalized) who were free of cardiovascular disease from the National Health and Nutrition Examination Surveys in 2013 through 2018. For all participants, we calculated the overall CVH score (range, 0 [lowest] to 100 [highest]), as well as the score for each component of diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure, using published American Heart Association definitions. Sample weights and design were incorporated in calculating prevalence estimates and standard errors using standard survey procedures. CVH scores were assessed across strata of age, sex, race and ethnicity, family income, and depression. RESULTS There were 23 409 participants, representing 201 728 000 adults and 74 435 000 children. The overall mean CVH score was 64.7 (95% CI, 63.9-65.6) among adults using all 8 metrics and 65.5 (95% CI, 64.4-66.6) for the 3 metrics available (diet, physical activity, and body mass index) among children and adolescents ages 2 through 19 years. For adults, there were significant differences in mean overall CVH scores by sex (women, 67.0; men, 62.5), age (range of mean values, 62.2-68.7), and racial and ethnic group (range, 59.7-68.5). Mean scores were lowest for diet, physical activity, and body mass index metrics. There were large differences in mean scores across demographic groups for diet (range, 23.8-47.7), nicotine exposure (range, 63.1-85.0), blood glucose (range, 65.7-88.1), and blood pressure (range, 49.5-84.0). In children, diet scores were low (mean 40.6) and were progressively lower in higher age groups (from 61.1 at ages 2 through 5 to 28.5 at ages 12 through 19); large differences were also noted in mean physical activity (range, 63.1-88.3) and body mass index (range, 74.4-89.4) scores by sociodemographic group. CONCLUSIONS The new Life's Essential 8 score helps identify large group and individual differences in CVH. Overall CVH in the US population remains well below optimal levels and there are both broad and targeted opportunities to monitor, preserve, and improve CVH across the life course in individuals and the population.
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Affiliation(s)
- Donald M Lloyd-Jones
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
| | - Hongyan Ning
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
| | - Darwin Labarthe
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
| | | | - Garima Sharma
- Johns Hopkins University School of Medicine, Baltimore, MD (G.S.)
| | - Wayne Rosamond
- University of North Carolina Gillings School of Public Health, Chapel Hill (W.R.)
| | - Randi E Foraker
- Washington University School of Medicine, St Louis, MO (R.E.F.)
| | - Terrie Black
- University of Massachusetts Amherst College of Nursing (T.B.)
| | | | - Norrina B Allen
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
| | - Cheryl Anderson
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla (C.A.)
| | | | - Amanda M Perak
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
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Hajek A, König HH, Buczak-Stec E, Rose LM, Kretzler B, Spinler K, Schiffner U, Aarabi G, Walther C. Regular childhood dental visits, health-related factors and quality of life in later life. Arch Gerontol Geriatr 2022; 99:104585. [DOI: 10.1016/j.archger.2021.104585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/25/2022]
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Wu X, Liu X, Liao W, Kang N, Sang S, Abdulai T, Niu M, He Y, Zhai Z, Pan M, Wang C, Li Y. The Association Between Ideal Cardiovascular Health and Health-Related Quality of Life in Adults: A Population-Based Cross-Sectional Study. Int J Public Health 2021; 66:592043. [PMID: 34744561 PMCID: PMC8565252 DOI: 10.3389/ijph.2021.592043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The study aimed to explore the association between Ideal cardiovascular health (ICH) and health-related quality of life (HRQoL) using the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) among rural population. Methods: This study included 20,683 participants aged 18–79 years from “the Henan Rural Cohort study”. Generalized linear and Tobit regression models were employed to explore the associations of ICH with EQ-5D-5L utility scores and visual analogue scale (VAS) scores, respectively. Results: The mean EQ-5D-5L utility scores and VAS scores were 0.962 ± 0.095 and 79.52 ± 14.02, respectively. Comparing with poor CVH participants (EQ-5D-5L utility scores and VAS scores: 0.954 ± 0.111 and 78.44 ± 14.29), people with intermediate and ideal CVH had higher EQ-5D-5L utility scores (0.969 ± 0.079 and 0.959 ± 0.099) and VAS scores (80.43 ± 13.65 and 79.28 ± 14.14). ICH scores were positively correlated with EQ-5D-5L utility scores (0.007 (0.004, 0.009)) and VAS scores (0.295 (0.143, 0.446)), respectively. Conclusions: Higher ICH scores is positive associated with better HRQoL in rural population, which suggests that improvement of cardiovascular health may help to enhance HRQoL among rural population.
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Affiliation(s)
- Xueyan Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ning Kang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shengxiang Sang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Tanko Abdulai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Miaomiao Niu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yaling He
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhihan Zhai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Mingming Pan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, China
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Castillo-Mayén R, Luque B, Rubio SJ, Cuadrado E, Gutiérrez-Domingo T, Arenas A, Delgado-Lista J, Pérez-Martínez P, Tabernero C. Positive psychological profiles based on perceived health clustering in patients with cardiovascular disease: a longitudinal study. BMJ Open 2021; 11:e050818. [PMID: 34006562 PMCID: PMC8130737 DOI: 10.1136/bmjopen-2021-050818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Psychological well-being and sociodemographic factors have been associated with cardiovascular health. Positive psychological well-being research is limited in the literature; as such, this study aimed to investigate how patients with cardiovascular disease could be classified according to their perceived mental and physical health, and to identify positive psychological profiles based on this classification and test their stability over time. DESIGN AND SETTING Longitudinal study with patients from a public hospital located in Córdoba (Spain). PARTICIPANTS This study comprised 379 cardiovascular patients (87.3% men) tested at three measurement points. OUTCOME MEASURES Participants reported their sociodemographic variables (age, sex, educational level, employment and socioeconomic status) at phase 1, while their perceived health and variables relating to positive psychological well-being were tested at this and two subsequent time points (average interval time: 9 months). RESULTS The two-step cluster analysis classified participants into three groups according to their mental and physical health levels, p<0.001: high (n=76), moderate (n=113) and low (n=189) perceived health clusters. Low perceived health was the largest cluster, comprising almost half of patients. Clusters significantly differed according to sex, p=0.002, and socioeconomic level, p=0.004. The profile analysis indicated that participants in the high perceived health cluster showed high positive affect, positivity, life satisfaction, and self-efficacy in emotion regulation, and less negative affect and use of passive strategies over the three measurement points (95% CI, all ps<0.01). Moreover, psychological profile stability for each cluster was generally found over an 18-month period, all ps<0.05. CONCLUSION Cardiovascular patients may differ in terms of their perceived health and, accordingly, in terms of other relevant variables. Perceived health clusters generated varying and generally stable psychological profiles based on positive psychological well-being variables. Psychological interventions should be adapted to patients' requirements.
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Affiliation(s)
- Rosario Castillo-Mayén
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, University of Cordoba, Córdoba, Spain
| | - Bárbara Luque
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, University of Cordoba, Córdoba, Spain
| | - Sebastián Jesús Rubio
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Specific Didactics, University of Cordoba, Córdoba, Spain
| | - Esther Cuadrado
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, University of Cordoba, Córdoba, Spain
| | - Tamara Gutiérrez-Domingo
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, University of Cordoba, Córdoba, Spain
| | - Alicia Arenas
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Department of Social Psychology, University of Seville, Sevilla, Spain
| | - Javier Delgado-Lista
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, Spain
| | - Pablo Pérez-Martínez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, Spain
| | - Carmen Tabernero
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Instituto de Neurociencias de Castilla y León, University of Salamanca, Salamanca, Spain
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Luque B, Castillo-Mayén R, Cuadrado E, Gutiérrez-Domingo T, Rubio SJ, Arenas A, Delgado-Lista J, Pérez Martínez P, Tabernero C. The Role of Emotional Regulation and Affective Balance on Health Perception in Cardiovascular Disease Patients According to Sex Differences. J Clin Med 2020; 9:E3165. [PMID: 33007817 PMCID: PMC7599936 DOI: 10.3390/jcm9103165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 11/17/2022] Open
Abstract
One of the challenges of aging is the increase of people with chronic diseases, such as cardiovascular disease (CVD). Men and women experience the disease differently. Therefore, it has an impact on how CVD is treated and its outcomes. This research analyzed the relationship between psychosocial variables and health promotion among cardiovascular patients, paying special attention to sex differences. A longitudinal study with cardiovascular patients (747 in phase 1 (122 women) and 586 in phase 2 (83 women)) was carried out. Participants were evaluated based on their sociodemographic characteristics, affective balance, regulatory negative affect self-efficacy, stress and anxiety regulation strategies, and perceived global health. Results showed that men presented significantly higher scores in positive affect, affective balance, and self-efficacy to regulate negative emotions, while women presented significantly higher scores in negative affect and the use of passive strategies to cope with stressful situations. Regression analyses showed that all psychological variables studied in phase 1 were significant predictors of health perception in phase 2. According to the results, it is necessary to include strategies to improve cardiovascular health through education and emotional regulation, with a gender focus.
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Affiliation(s)
- Bárbara Luque
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Psychology, University of Córdoba, 14071 Córdoba, Spain
| | - Rosario Castillo-Mayén
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Psychology, University of Córdoba, 14071 Córdoba, Spain
| | - Esther Cuadrado
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Psychology, University of Córdoba, 14071 Córdoba, Spain
| | - Tamara Gutiérrez-Domingo
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Psychology, University of Córdoba, 14071 Córdoba, Spain
| | - Sebastián J. Rubio
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Didactics of Experimental Sciences, University of Córdoba, 14071 Cordoba, Spain
| | - Alicia Arenas
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Department of Social Psychology, University of Seville, 41018 Seville, Spain
| | - Javier Delgado-Lista
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofía University Hospital, 14004 Córdoba, Spain
- Department of Medicine (Medicine, Dermatology and Otorhinolaryngology), University of Córdoba, 14004 Cordoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28007 Madrid, Spain
| | - Pablo Pérez Martínez
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofía University Hospital, 14004 Córdoba, Spain
- Department of Medicine (Medicine, Dermatology and Otorhinolaryngology), University of Córdoba, 14004 Cordoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28007 Madrid, Spain
| | - Carmen Tabernero
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain; (E.C.); (T.G.-D.); (S.J.R.); (A.A.); (J.D.-L.); (P.P.M.)
- Instituto de Neurociencias de Castilla y León (INCYL), University of Salamanca, 37007 Salamanca, Spain
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Angell SY, McConnell MV, Anderson CA, Bibbins-Domingo K, Boyle DS, Capewell S, Ezzati M, de Ferranti S, Gaskin DJ, Goetzel RZ, Huffman MD, Jones M, Khan YM, Kim S, Kumanyika SK, McCray AT, Merritt RK, Milstein B, Mozaffarian D, Norris T, Roth GA, Sacco RL, Saucedo JF, Shay CM, Siedzik D, Saha S, Warner JJ. The American Heart Association 2030 Impact Goal: A Presidential Advisory From the American Heart Association. Circulation 2020; 141:e120-e138. [DOI: 10.1161/cir.0000000000000758] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Each decade, the American Heart Association (AHA) develops an Impact Goal to guide its overall strategic direction and investments in its research, quality improvement, advocacy, and public health programs. Guided by the AHA’s new Mission Statement, to be a relentless force for a world of longer, healthier lives, the 2030 Impact Goal is anchored in an understanding that to achieve cardiovascular health for all, the AHA must include a broader vision of health and well-being and emphasize health equity. In the next decade, by 2030, the AHA will strive to equitably increase healthy life expectancy beyond current projections, with global and local collaborators, from 66 years of age to at least 68 years of age across the United States and from 64 years of age to at least 67 years of age worldwide. The AHA commits to developing additional targets for equity and well-being to accompany this overarching Impact Goal. To attain the 2030 Impact Goal, we recommend a thoughtful evaluation of interventions available to the public, patients, providers, healthcare delivery systems, communities, policy makers, and legislators. This presidential advisory summarizes the task force’s main considerations in determining the 2030 Impact Goal and the metrics to monitor progress. It describes the aspiration that these goals will be achieved by working with a diverse community of volunteers, patients, scientists, healthcare professionals, and partner organizations needed to ensure success.
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