European Journal of Cardiovascular Prevention & Rehabilitation最新文献

{"title":"A model for undertaking effectiveness and cost-effectiveness analyses of primary preventive strategies in cardiovascular disease.","authors":"Danny Liew,&nbsp;Stephen S Lim,&nbsp;Melanie Bertram,&nbsp;John J McNeil,&nbsp;Theo Vos","doi":"10.1097/01.hjr.0000224488.03221.97","DOIUrl":"https://doi.org/10.1097/01.hjr.0000224488.03221.97","url":null,"abstract":"<p><strong>Background: </strong>Clinical trials generally provide strong evidence of the efficacy of cardiovascular preventive strategies, but poor evidence of their 'real-life' utility, in terms of effectiveness and cost-effectiveness.</p><p><strong>Design and methods: </strong>The Cardiovascular Disease Prevention Model is presented, which represents a means of extrapolating the results of clinical trials to a broader, more relevant context. The model is configured as a decision-analysis tree, and underpinned by life-course analysis and Markov processes. Uncertainty and sensitivity analyses are undertaken by Monte Carlo simulation.</p><p><strong>Results: </strong>The results of effectiveness and cost-effectiveness analyses of a hypothetical preventive intervention are presented to demonstrate the outputs of the model. The potential impact and efficiency of the intervention are made obvious.</p><p><strong>Conclusions: </strong>The Cardiovascular Disease Prevention Model offers a means to translate the results of trials of cardiovascular preventive interventions, in order to inform clinical and public health practice, as well as health policy.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":" ","pages":"515-22"},"PeriodicalIF":0.0,"publicationDate":"2006-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000224488.03221.97","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26168784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of exercise training heart rate in patients on beta-blockers after myocardial infarction.","authors":"Jean-Yves Tabet,&nbsp;Philippe Meurin,&nbsp;Ahmed Ben Driss,&nbsp;Gabriel Thabut,&nbsp;Helene Weber,&nbsp;Nathalie Renaud,&nbsp;Ngaralbaye Odjinkem,&nbsp;Alain Cohen Solal","doi":"10.1097/01.hjr.0000209813.05573.4d","DOIUrl":"https://doi.org/10.1097/01.hjr.0000209813.05573.4d","url":null,"abstract":"<p><strong>Background: </strong>In patients with coronary artery disease, the target intensity-level of exercise training is usually based on a training heart rate that aims to be close to the upper level of metabolic aerobic exercise.</p><p><strong>Aim: </strong>We intended to evaluate whether a training heart rate calculated with the Karvonen formula after a conventional exercise test is comparable with the heart rate at the anaerobic threshold in patients after myocardial infarction treated with beta-blockers and if not to propose a new formula.</p><p><strong>Methods and results: </strong>In this multicenter prospective study, 115 consecutive beta-blocked patients recovering from myocardial infarction performed a cardiopulmonary exercise test to determine the anaerobic threshold. The training heart rate determined by the Karvonen formula was compared with the heart rate at the anaerobic threshold in a derivation sample (n=58) and a validation sample (n=57) of patients. The Karvonen training heart rate was significantly lower than the heart rate at the anaerobic threshold (91+/-5 versus 102+/-17 bpm, P<0.0001) in the first sample of patients and this difference was clinically relevant in 40% of patients. Thus, a 'modified Karvonen training heart rate', equal to 0.8xx(maximum heart rate-resting heart rate)+resting heart rate, was calculated by linear regression in the derivation sample and prospectively assessed in the validation sample. The modified Karvonen training heart rate was closer to the heart rate at the anaerobic threshold than the Karvonen training heart rate, and the difference between the modified Karvonen training heart rate and the heart rate at the anaerobic threshold was clinically relevant in only 5% of patients.</p><p><strong>Conclusion: </strong>The Karvonen formula underestimates the heart rate at the anaerobic threshold in beta-blocked patients, which may lead to undertraining of patients with coronary artery disease; we propose another formula more adapted to these patients.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":" ","pages":"538-43"},"PeriodicalIF":0.0,"publicationDate":"2006-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000209813.05573.4d","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26168635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of epidemiological studies on drinking water hardness and cardiovascular diseases.","authors":"Silvano Monarca,&nbsp;Francesco Donato,&nbsp;Ilaria Zerbini,&nbsp;Rebecca L Calderon,&nbsp;Gunther F Craun","doi":"10.1097/01.hjr.0000214608.99113.5c","DOIUrl":"https://doi.org/10.1097/01.hjr.0000214608.99113.5c","url":null,"abstract":"Background Major risk factors do not entirely explain the worldwide variability of morbidity and mortality due to cardiovascular disease. Environmental exposures, including drinking water minerals may affect cardiovascular disease risks. Method We conducted a qualitative review of the epidemiological studies of cardiovascular disease and drinking water hardness and calcium and magnesium levels. Results Many but not all ecological studies found an inverse (i.e., protective) association between cardiovascular disease mortality and water hardness, calcium, or magnesium levels; but results are not consistent. Some case-control studies and one cohort study found either a reduced cardiovascular disease mortality risk with increased drinking water magnesium levels or an increased risk with low magnesium levels. However, the analytical studies provide little evidence that cardiovascular risks are associated with drinking water hardness or calcium levels. Conclusion Information from epidemiological and other studies supports the hypothesis that a low intake of magnesium may increase the risk of dying from, and possibly developing, cardiovascular disease or stroke. Thus, not removing magnesium from drinking water, or in certain situations increasing the magnesium intake from water, may be beneficial, especially for populations with an insufficient dietary intake of the mineral.","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":" ","pages":"495-506"},"PeriodicalIF":0.0,"publicationDate":"2006-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000214608.99113.5c","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26168782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation Part III: Interpretation of cardiopulmonary exercise testing in chronic heart failure and future applications.","authors":"","doi":"10.1097/01.hjr.0000201518.43837.bc","DOIUrl":"https://doi.org/10.1097/01.hjr.0000201518.43837.bc","url":null,"abstract":"<p><p>Optimal use of cardiopulmonary exercise testing (CPET) in clinical practice and chronic heart failure (CHF) requires appropriate data presentation and a flexible interpretative strategy. The greatest potential impact on the decision-making process may rest not on the value of any individual measurement, although some are obviously more important than others, but rather on their integrative use. Such an integrative approach relies on interrelationship, trending phenomena and patterns of key gas exchange variable responses. An multiparametric approach will be discussed in different clinical applications, for exercise prescription and monitoring, functional evaluation of drug therapy or cardiac resynchronisation therapy efficacy, and risk stratification. The role of CPET in the daily clinical decision-making process will be underscored. Future indications of CPET will be addressed, suggesting and promoting an extended candidacy either to all CHF patients, including those at high risk or most vulnerable, such as female, elderly patients, and patients with implantable cardioverter defibrillator or in every clinical setting where objective definition of exercise capacity provides implications for medical, surgical, and social decision making.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":" ","pages":"485-94"},"PeriodicalIF":0.0,"publicationDate":"2006-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000201518.43837.bc","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26168781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost-effectiveness of drug treatments for primary prevention of cardiovascular disease: a modelling study.","authors":"Tom Marshall","doi":"10.1097/01.hjr.0000230098.63277.61","DOIUrl":"https://doi.org/10.1097/01.hjr.0000230098.63277.61","url":null,"abstract":"<p><strong>Background: </strong>Efficient prevention policies need to be informed by knowledge of the cost-effectiveness of preventive treatments. This paper calculates the cost-effectiveness of aspirin, antihypertensive treatments and statins for prevention of cardiovascular disease.</p><p><strong>Design: </strong>The investigation is a modelling study.</p><p><strong>Methods: </strong>Ten-year cardiovascular risks and treatment eligibility were determined for each individual in a population of 5603 obtained from the Health Survey of England. Using published costs and evidence of effectiveness the cost-effectiveness of treating each eligible individual was determined over a 10-year time horizon. The marginal cost-effectiveness of additional antihypertensive drugs and increasing doses of statins were determined and a sensitivity analysis was carried out.</p><p><strong>Results: </strong>Of the 5603 individuals 27.5% (95% confidence interval, 26.3-28.7%) were eligible for at least one treatment: the majority of these were eligible for all three. Cost per cardiovascular disease event prevented is strongly determined by pretreatment cardiovascular disease risk. In three-quarters of patients eligible for all three treatments, the lowest cost per event prevented was with aspirin and in the remainder with two-drug antihypertensive treatment. The marginal costs per event prevented were highest with the addition of a fourth antihypertensive drug and statins. These findings depend on the use of low-cost antihypertensives but are otherwise robust to a wide range of assumptions.</p><p><strong>Conclusions: </strong>Modelling the cost-effectiveness of treatments to prevent cardiovascular disease is feasible and provides valuable information. Cost-effectiveness analysis argues for more widespread use of aspirin and two-drug antihypertensive treatment and against the use of four-drug antihypertensive treatment or statins.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":" ","pages":"523-8"},"PeriodicalIF":0.0,"publicationDate":"2006-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000230098.63277.61","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26168785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topic category: Prevention","authors":"A. Bader, F. Sahin, H. Bezirkan","doi":"10.1097/01.hjr.0000221861.96544.43","DOIUrl":"https://doi.org/10.1097/01.hjr.0000221861.96544.43","url":null,"abstract":"screening—who profits? C Graf, B Koch, B Bjarnason-Wehrens, W Tokarski, S Dordel, HG Predel German Sport University, Germany Background Obesity in childhood is on the increase. Therefore countermeasures are necessary, but till now no valid method is available. Step Two is a schooland family-based intervention consisting of extra lessons, healthy nutrition and physical education for overweight/obese children in primary schools. This paper provides changes in anthropometric, cardiovascular and obesity parameters between intervention children (IG), nonparticipants (NP) in intervention, and controls (CG). Methods In 1678 children anthropometric data were recorded; BMI and BMI–SDS were calculated. Blood pressure was measured after 5 min at rest. 121 overweight/obese children at 3 intervention schools were invited to take part in the intervention. 40 of them completed the program from November 2003 till July 2004 (intervention group), 74 were invited, but did not take part (‘‘nonparticipants’’); the remaining 8 children were not considered for various reasons. 155 overweight/obese children from 4 other schools served as controls. Results Afterwards the IG shows a lower increase of the BMI ( + 0.3 ± 1.3 versus + 0.7 ± 1.2 kg/m) and an approximately three times higher diminution of the BMI–SDS in comparison with the CG ( – 0.16 ± 0.3 versus – 0.05 ± 0.3). Systolic blood pressure could significantly be lowered by 9.4 ± 20.0 mmHg in the IG, but increased in the CG around 0.4 ± 16.8 mmHg. In the group of NP, the increase of the BMI ( + 0.5 ± 1.3 kg/m) was less, however the reduction of the BMI– SDS ( – 0.10 ± 0.31) and systolic blood pressure ( – 5.7 ± 15.7 mmHg) was higher than in the CG. It also appeared that overweight but not obese children benefited from a screening examination alone. Conclusion Preventive measures are necessary and effective for overweight and obese primary school children. The screening itself seems also to have a small positive effect, especially for overweight children. Sustainability of the observed improvements over a longer period remains to be confirmed.","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"13 1","pages":"S42 - S73"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000221861.96544.43","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61597253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topic category: Exercise Physiology","authors":"J. Zub, A. Wrześniowski, W. Grochulska, K. Oleszczyk","doi":"10.1097/01.hjr.0000221858.11792.2f","DOIUrl":"https://doi.org/10.1097/01.hjr.0000221858.11792.2f","url":null,"abstract":"and various degrees of coronary artery disease E Klainman, A Landau, G Fink ‘‘GEFEN’’-Cardiac Health Center, Givatayim, ISRAEL Background Recovery indices of oxygen consumption (VO2) kinetics were observed as important factors to differ patients (pts) with various degrees of chronic heart failure (CHF). The significance of the relationship between such indices and various degrees of coronary artery disease (CAD) isn’t yet well established. Aim of study To find the relationship between recovery VO2-kinetics indices and various degrees of CAD, in comparison to normal individuals. Methods 70 pts, all men, were studied. They were divided in four groups according to their CAD degree as follows: Group A: Normal (control group; n = 20); Group B: one vessel disease (1VD; n = 26); Group C: 2VD (n = 12); and Group D: 3VD (n = 12). All pts underwent a cardiopulmonary exercise test (CPET) and the following recovery indices were measured: 1. half time recovery of VO2 (1/2tRec); 2. half time recovery of oxygen pulse (1/2Rec-O2P); and 3. total time recovery of VO2 (TtRec-VO2), till RER reached value of 1 or less. Results","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"13 1","pages":"S33 - S41"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000221858.11792.2f","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61597174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topic category: Rehabilitation","authors":"","doi":"10.1097/01.hjr.0000221859.88920.52","DOIUrl":"https://doi.org/10.1097/01.hjr.0000221859.88920.52","url":null,"abstract":"","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"13 1","pages":"S101 - S74"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000221859.88920.52","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61597187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topic category: Epidemiology","authors":"Q. Qiao, P. Jousilahti, R. Antikainen, J. Tuomilehto","doi":"10.1097/01.hjr.0000220578.96645.7a","DOIUrl":"https://doi.org/10.1097/01.hjr.0000220578.96645.7a","url":null,"abstract":"mortality among patients with type 2 diabetes S Bidel, G Hu, Q Qiao, P Jousilahti, R Antikainen, J Tuomilehto National Public Health Institute and University of Helsinki Helsinki, Finland Context Higher habitual coffee drinking has been associated with a lower risk of developing type 2 diabetes. The relation between coffee consumption and risk of cardiovascular disease (CVD) has been examined in many studies but the issue has remained controversial. Objective To assess the association between coffee consumption and CVD mortality among patients with type 2 diabetes. Design, participants and measurement We prospectively followed 3837 randomly ascertained Finnish patients with type 2 diabetes aged 25–74 years with average follow-up of 20.8 years. Coffee consumption and other study parameters were determined at baseline using standardized measurements. The International Classification of Diseases Revisions 8, 9 and 10 were used to identify coronary heart disease (CHD), CVD and stroke cases using computerized record linkage to the national Death Registry. The associations between coffee consumption at baseline and risk of total, CVD, CHD, and stroke mortality were analyzed by using Cox proportional hazards models. Results During the average follow-up of 20.8 years, 1471 deaths were recorded, of which 909 were coded as CVD, 598 as CHD and 210 as stroke. The multivariate-adjusted hazard ratios (HRs) in participants who drank 0–2, 3–4, 5–6, and X Ý7 cups of coffee daily were 1.00, 0.77 (95% confidence interval [CI], 0.65–0.91), 0.68 (95% CI, 0.58–0.80), 0.70 (95% CI, 0.59–0.85) for total mortality (P < 0.001 for trend), 1.00, 0.79 (95% CI, 0.64–0.97), 0.70 (95% CI, 0.57–0.86), 0.71 (95% CI, 0.56– 0.90) for CVD mortality (P = 0.006 for trend), 1.00, 0.78 (95% CI, 0.60– 1.01), 0.70 (95% CI, 0.54–0.90), 0.63 (95% CI, 0.47–0.84) for CHD mortality (P = 0.014 for trend), and 1.00, 0.77 (95% CI, 0.50–1.19), 0.64 (95% CI, 0.41–0.99), 0.90 (95% CI, 0.56–1.45) for stroke mortality (P = 0.12 for trend), respectively. Conclusion In this large prospective study we found that in type 2 diabetic patients coffee drinking is associated with reduced total, CVD and CHD mortality.","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"13 1","pages":"S14 - S32"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000220578.96645.7a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61597104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topic category: Sports Cardiology","authors":"","doi":"10.1097/01.hjr.0000220579.96645.33","DOIUrl":"https://doi.org/10.1097/01.hjr.0000220579.96645.33","url":null,"abstract":"","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"13 1","pages":"S102 - S105"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.hjr.0000220579.96645.33","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61597166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}