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Castillo-García A, Valenzuela PL, Saco-Ledo G, Carrera-Bastos P, Ruilope LM, Santos-Lozano A, Lucia A. Lifestyle and cardiovascular risk in working young adults: insights from a nationwide Spanish cohort. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024:S1885-5857(24)00069-0. [PMID: 38423178 DOI: 10.1016/j.rec.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION AND OBJECTIVES This study aimed to describe the cardiovascular risk profile of working young adults from Spain and its association with lifestyle. METHODS Participants (18-30 years) were recruited from a nationwide cohort of economically active adults insured by a large occupational risk prevention company, with data obtained from routine medical assessments. The participants were categorized as having an "unhealthy" cardiovascular risk profile based on the presence of prediabetes/diabetes, prehypertension/hypertension, or hypercholesterolemia, or a "healthy" profile if these conditions were completely absent. The association with lifestyle factors (weight, physical activity, sleeping characteristics, alcohol consumption, smoking) was assessed. RESULTS A total of 78 421 young adults (27±2 years, 36% female) were evaluated at baseline. The "unhealthy" cardiovascular risk profile was prevalent (18%) and inversely associated (OR, 0.64; 95%CI, 0.57-0.80) with an optimal lifestyle (normal weight, regular physical activity, no drinking/smoking, and good sleep). The latter condition was found in only 3.5% of the participants. On the other hand, prospective analyses in 44 776 participants (median follow-up=2 [range 2-5] years) showed that 2.0% transitioned from a "healthy" to an "unhealthy" profile. Being physically active (OR, 0.95; 95%CI, 0.81-0.99) and having a normal weight (OR, 0.61; 95%CI, 0.51-0.70) were associated with a lower likelihood of this transition. No consistent associations were found for other lifestyle factors. CONCLUSIONS The prevalence of cardiovascular risk factors is high in economically active young Spanish adults. An unhealthy cardiovascular risk profile is inversely associated with an optimal lifestyle, but the latter is highly infrequent in this population.
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Affiliation(s)
- Adrián Castillo-García
- Departamento de Biología de Sistemas, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain. https://twitter.com/@adrian_science
| | - Pedro L Valenzuela
- Departamento de Biología de Sistemas, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain.
| | - Gonzalo Saco-Ledo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Pedro Carrera-Bastos
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain; Centre for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Luis M Ruilope
- Grupo de Investigación Traslacional en Hipertensión y Enfermedad Cardiorrenal, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Alejandro Santos-Lozano
- Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain; i+HeALTH Strategic Research Group, Universidad Europea Miguel de Cervantes, Valladolid, Spain
| | - Alejandro Lucia
- Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain; Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
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Arezomand M, Dehghan M, Rigi ZE, Fatehi F, Shahrbabaki PM. The effect of using a sports application on the quality of sleep in patients with heart failure: a randomized clinical trial study. BMC Sports Sci Med Rehabil 2024; 16:15. [PMID: 38217022 PMCID: PMC10787377 DOI: 10.1186/s13102-023-00803-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Patients with heart failure often suffer from sleep disorders. Due to the side effects of medications used to treat this disorder, non-pharmacological methods may be used to improve these patients' sleep quality. This study aimed to determine the effect of a sports application on sleep quality in patients with heart failure. METHODS In this single-blinded randomized clinical trial, 60 patients aged 30-70 referred to Shafa Hospital in Kerman were randomly assigned to control (n = 30) and intervention (n = 30) groups based on convenience sampling. The intervention group used the sports application for eight consecutive weeks. Data was collected using a demographic questionnaire and the Pittsburgh Sleep Quality Index (PSQI). An independent t-test and a Mann-Whitney U test were used for comparisons between groups and paired t-tests and Wilcoxon tests were used for comparisons within groups. RESULTS The data analysis revealed a significant difference in sleep quality scores between the two groups after the intervention, meaning that the intervention group had better sleep quality than the control group (P < 0.05). CONCLUSIONS As a result of the study, it was found that the sport application improved the quality of sleep in patients with heart failure. Our recommendation is for healthcare providers to use this sports application to present educational content related to physical activity and improve the sleep quality of patients. TRIAL REGISTRATION Iranian Registry of Clinical Trials: IRCT. 2019123045475N1." Registered 16 December 2019.
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Affiliation(s)
- Mohsen Arezomand
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Ebrahimi Rigi
- Department of Nursing, School of Nursing and Midwifery, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Farhad Fatehi
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Centre for Online Health, The University of Queensland, Brisbane, Australia
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Valenzuela PL, Santos-Lozano A, Saco-Ledo G, Castillo-García A, Lucia A. Obesity, cardiovascular risk, and lifestyle: cross-sectional and prospective analyses in a nationwide Spanish cohort. Eur J Prev Cardiol 2023; 30:1493-1501. [PMID: 37317985 DOI: 10.1093/eurjpc/zwad204] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/16/2023]
Abstract
AIMS To assess whether overweight and obesity are independently associated with cardiometabolic health [as categorized based on the presence/absence of cardiovascular disease (CVD) risk factors (diabetes, hypercholesterolaemia, or hypertension)], and the role of lifestyle on this association. METHODS AND RESULTS A nationwide cohort of Spanish adults (18-64 years) was studied using a cross-sectional design and prospective observational design. Lifestyle-related factors (physical activity, sleeping characteristics, alcohol drinking, and smoking) were registered, and participants were classified as having an 'unhealthy' or 'healthy' cardiometabolic status attending to the presence or absence, respectively, of ≥1 CVD risk factor. A number of 596 111 participants (44 ± 9 years, 67% male) were studied at baseline, with prospective analyses in a subcohort [n = 302 061; median follow-up, 2 years (range, 2 to 5)]. Compared to normal weight, overweight and obesity were associated with a higher prevalence [odds ratio, 1.67 (95% confidence interval, 1.61-1.67) and 2.70 (2.69-2.78), respectively] and incidence [1.62 (1.59-1.67) and 2.70 (2.63-2.78)] of an unhealthy cardiometabolic status. Meeting physical activity guidelines reduced the odds of an unhealthy cardiometabolic status at baseline [0.87 (0.85-0.88)] among individuals with overweight/obesity, as well as of transitioning from a healthy status to an unhealthy status during the follow-up [0.87 (0.84-0.94)]. No significant associations were found for the remainder of lifestyle factors. CONCLUSION Overweight and obesity are independently associated with an unhealthy cardiometabolic status. Regular physical activity attenuates not only the prevalence but also the incidence of CVD risk factors.
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Affiliation(s)
- Pedro L Valenzuela
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), 7ª Planta, Bloque D., Av. de Córdoba s/n, 28041 Madrid, Spain
- Department of Systems Biology, University of Alcalá, C/ 19, Av. de Madrid, Km 33,600, Alcalá de Henares, 28871 Madrid, Spain
| | - Alejandro Santos-Lozano
- i+HeALTH, European University Miguel de Cervantes, C/ del Padre Julio Chevalier, 2, 47012 Valladolid, Spain
| | - Gonzalo Saco-Ledo
- Faculty of Sport Sciences, Universidad Europea de Madrid, C. Tajo, s/n, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Adrián Castillo-García
- Department of Systems Biology, University of Alcalá, C/ 19, Av. de Madrid, Km 33,600, Alcalá de Henares, 28871 Madrid, Spain
| | - Alejandro Lucia
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), 7ª Planta, Bloque D., Av. de Córdoba s/n, 28041 Madrid, Spain
- Faculty of Sport Sciences, Universidad Europea de Madrid, C. Tajo, s/n, Villaviciosa de Odón, 28670 Madrid, Spain
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Ordovas JM, Rios-Insua D, Santos-Lozano A, Lucia A, Torres A, Kosgodagan A, Camacho JM. A Bayesian network model for predicting cardiovascular risk. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 231:107405. [PMID: 36796167 DOI: 10.1016/j.cmpb.2023.107405] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 01/17/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Cardiovascular diseases are the leading death cause in Europe and entail large treatment costs. Cardiovascular risk prediction is crucial for the management and control of cardiovascular diseases. Based on a Bayesian network built from a large population database and expert judgment, this work studies interrelations between cardiovascular risk factors, emphasizing the predictive assessment of medical conditions, and providing a computational tool to explore and hypothesize such interrelations. METHODS We implement a Bayesian network model that considers modifiable and non-modifiable cardiovascular risk factors as well as related medical conditions. Both the structure and the probability tables in the underlying model are built using a large dataset collected from annual work health assessments as well as expert information, with uncertainty characterized through posterior distributions. RESULTS The implemented model allows for making inferences and predictions about cardiovascular risk factors. The model can be utilized as a decision- support tool to suggest diagnosis, treatment, policy, and research hypothesis. The work is complemented with a free software implementing the model for practitioners' use. CONCLUSIONS Our implementation of the Bayesian network model facilitates answering public health, policy, diagnosis, and research questions concerning cardiovascular risk factors.
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Affiliation(s)
- J M Ordovas
- Nutrition and Genomics, JM-USDA-HNRCA, Tufts University, Boston, MASS, USA
| | | | - A Santos-Lozano
- i+Health, Dpt. Health Sciences, European University Miguel de Cervantes, Valladolid, Spain; Physical Activity and Health Research Group, Inst. Inv. Sanitaria Hospital 12 de Octubre, Madrid, Spain
| | - A Lucia
- Fac. Sports Sciences, Universidad Europea de Madrid, Madrid, Spain; Physical Activity and Health Research Group, Inst. Inv. Sanitaria Hospital 12 de Octubre, Madrid, Spain
| | | | - A Kosgodagan
- Inst. de Mathématiques Apliqueés, Université Catholique de L'Ouest, Angers, France
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Ellis J, Ferini-Strambi L, García-Borreguero D, Heidbreder A, O’Regan D, Parrino L, Selsick H, Penzel T. Chronic Insomnia Disorder across Europe: Expert Opinion on Challenges and Opportunities to Improve Care. Healthcare (Basel) 2023; 11:healthcare11050716. [PMID: 36900721 PMCID: PMC10001099 DOI: 10.3390/healthcare11050716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
One in ten adults in Europe have chronic insomnia, which is characterised by frequent and persistent difficulties initiating and/or maintaining sleep and daily functioning impairments. Regional differences in practices and access to healthcare services lead to variable clinical care across Europe. Typically, a patient with chronic insomnia (a) will usually present to a primary care physician; (b) will not be offered cognitive behavioural therapy for insomnia-the recommended first-line treatment; (c) will instead receive sleep hygiene recommendations and eventually pharmacotherapy to manage their long-term condition; and (d) will use medications such as GABA receptor agonists for longer than the approved duration. Available evidence suggests that patients in Europe have multiple unmet needs, and actions for clearer diagnosis of chronic insomnia and effective management of this condition are long overdue. In this article, we provide an update on the clinical management of chronic insomnia in Europe. Old and new treatments are summarised with information on indications, contraindications, precautions, warnings, and side effects. Challenges of treating chronic insomnia in European healthcare systems, considering patients' perspectives and preferences are presented and discussed. Finally, suggestions are provided-with healthcare providers and healthcare policy makers in mind-for strategies to achieve the optimal clinical management.
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Affiliation(s)
- Jason Ellis
- Department of Psychology, Northumbria University, Newcastle NE1 8ST, UK
| | - Luigi Ferini-Strambi
- Department of General Psychology, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | | | - Anna Heidbreder
- Department of Neurology, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - David O’Regan
- Faculty of Life Sciences and Medicine, King’s College, London WC2R 2LS, UK
- Disorder Centre, Guy’s Hospital, London SE1 9RT, UK
| | - Liborio Parrino
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy
| | - Hugh Selsick
- Insomnia and Behavioural Sleep Medicine Clinic, University College London Hospitals, London NW1 2PG, UK
| | - Thomas Penzel
- Interdisciplinary Centre of Sleep Medicine, Medicine Centre, Charité Universitätsmedizin, 10117 Berlin, Germany
- Correspondence:
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Kawada T. Self-reported sleep characteristics and cardiovascular disease risk factors. Eur J Clin Invest 2022; 53:e13949. [PMID: 36583630 DOI: 10.1111/eci.13949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Bunkyo-Ku, Japan
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