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Madujibeya I, Misook L, Lennie T, Mudd-Martin G, Biddle M, Moser D. 7500 steps per day is associated with lower cardiovascular risk in rural residents with a high prevalence of sedentary lifestyle. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Sedentary lifestyle is one of the modifiable risk factors that account for the high prevalence of cardiovascular diseases (CVD) in the rural areas.1,2 Daily step counting, using wearable devices, is increasingly used to monitor physical activity levels in interventions targeting CVD risk reduction in the rural areas.3,4 However, there is a lack of evidence to support a daily step count threshold that may reduce CVD risk among rural residents. The purpose of this study was to examine the relationship between daily step count cut-points and CVD risk.
Methods
This secondary analysis included 312 adults living in the rural areas in the southern United States. Daily step counts from pedometers were collected for 14 consecutive days. Established cut-points were used to categorize participants into groups based on mean daily step count as sedentary (≤ 5000 steps/day), less active (5000 -7499 steps/per), and physically active (≥7500 steps/day).5-7 CVD risk was measured with the Framingham risk score. Generalized additive models were used to examine differences among the 3 activity groups in Framingham risk score, controlling for educational level, perceived physical health status, depressive, marital status, and years of residence in a rural county.
Results
Among the participants (75% female, mean age 50.1 (±13.6) years), 40.7% were sedentary, 35.2% were less active, and 24.0% were physically active. The average Framingham risk score was 11.2% (±9.4%). Framingham risk scores were 1.7% lower in the less active compared to the sedentary group, but the effect was not significant (p < .11), and 2.6% lower in the physically active compared to the sedentary group (p < .04). The model accounted for 22% of the variation in Framingham risk scores.
Conclusion
These findings indicate that rural residents who averaged 7500 steps or more per day had lower CVD risk, and the difference is clinically significant.
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Affiliation(s)
- I Madujibeya
- University of Kentucky, College of Nursing , Lexington, United States of America
| | - L Misook
- University of Kentucky, College of Nursing , Lexington, United States of America
| | - T Lennie
- University of Kentucky, College of Nursing , Lexington, United States of America
| | - G Mudd-Martin
- University of Kentucky, College of Nursing , Lexington, United States of America
| | - M Biddle
- University of Kentucky, College of Nursing , Lexington, United States of America
| | - D Moser
- University of Kentucky, College of Nursing , Lexington, United States of America
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Saleh Z, Lennie T, Moser D. P4540Obesity in patients with heart failure and without diabetes mellitus is associated with longer event-free survival only among those with high dietary sodium intake. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Obesity is paradoxically associated with better short- and long-term outcomes in patients with heart failure (HF) and without diabetes mellitus (DM). While excessive dietary sodium intake is common among obese persons, its impact on the association between obesity and outcomes has not been considered.
Aim
To determine whether dietary sodium intake levels would affect the association between obesity and better outcomes in patients with HF and without DM.
Method
A sample of 129 patients (age 60±12.4 years; 30% female) provided a single 24-hour urine collection sample to estimate dietary sodium intake. Patients were divided into 4 groups based on body mass index (BMI) and the sodium intake recommendation for HF of 3g/day (obese with high sodium intake [n=41; 32%], obese with low sodium intake [n=16; 12%], non-obese with high sodium intake [n=35; 27%], and non-obese with low sodium intake [n=37; 29%]). Patients were followed-up during an average period of 395 days to determine time to first event of all-cause hospitalization or death. Cox regression was used to determine the association between obesity and outcomes in the context of sodium intake after controlling for age, gender, NYHA class (I II vs. III IV) and LVEF.
Results
There were 41 patients (31.8%) who had an event of all-cause hospitalization or death. Obese patients with high sodium intake had 61% lower risk for events than those non-obese with low dietary sodium intake (figure). There were no differences in the event-free survival among other groups.
Conclusion
These data suggest that dietary sodium intake may be particularly important for obese patients with HF and without DM.
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Affiliation(s)
- Z Saleh
- The University of Jordan, School of Nursing, Amman, Jordan
| | - T Lennie
- University of Kentucky, College of Nursing, Lexington, United States of America
| | - D Moser
- University of Kentucky, College of Nursing, Lexington, United States of America
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Lee K, Lennie T, Chung M, Westneat S, Biddle M, Frazier S, Moser D, Heo S, Wu J. 9. Depressive symptoms as a mediator of the relationship between health-related quality of life and cardiac event-free survival in patients with heart failure. Heart Lung 2012. [DOI: 10.1016/j.hrtlng.2012.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Heo S, Moser D, Lennie T, Chung M, Pressler S, Dunbar S. Factors Associated With Perceived Control in Patients With Heart Failure. Heart Lung 2009. [DOI: 10.1016/j.hrtlng.2009.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Moser D, Chung M, Wu J, Lennie T. FP18 Nonadherence, Not Altered Autonomic Nervous Tone, Mediates the Link between Depressive Symptoms and Rehospitalization or Mortality in Patients with Heart Failure. Eur J Cardiovasc Nurs 2009. [DOI: 10.1016/s1474-5151(09)60057-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D.K. Moser
- University of Kentucky, College of Nursing, Lexington, United States of America
| | - M.L. Chung
- University of Kentucky, Lexington, Kentucky, United States of America
| | - J.R. Wu
- University of Kentucky, Lexington, Kentucky, United States of America
| | - T.A. Lennie
- University of Kentucky, Lexington, Kentucky, United States of America
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Lee C, Riegel B, Driscoll A, Suwanno J, Moser D, Lennie T, Dickson V, Cameron J, Worrall-Carter L. FP9 Gender is not a Determinant of Heart Failure Self-Care. Eur J Cardiovasc Nurs 2009. [DOI: 10.1016/s1474-5151(09)60048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- C.S. Lee
- University of Pennsylvania, Philadelphia, United States of America
| | - B. Riegel
- University of Pennsylvania, Philadelphia, United States of America
| | | | - J. Suwanno
- Walailak University, Nakhon Si Thammarat, Thailand
| | - D.K. Moser
- University of Kentucky, Lexington, United States of America
| | - T.A. Lennie
- University of Kentucky, Lexington, United States of America
| | - V.V. Dickson
- New York University, New York, United States of America
| | - J. Cameron
- Australian Catholic University, Melbourne, Australia
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