European Journal of Cardiovascular Prevention & Rehabilitation最新文献

{"title":"The real role of exercise versus medication in lipid profile of patients referred to a cardiac rehabilitation program.","authors":"Ali Kabir, Nizal Sarrafzadegan","doi":"10.1097/HJR.0b013e3283386406","DOIUrl":"https://doi.org/10.1097/HJR.0b013e3283386406","url":null,"abstract":"We enjoyed the letter by Lakusic and Granec; however, our response is delayed because of unawareness of their letter. First, as we have mentioned in our paper, we have considered all other antilipid therapies, and not only those statins, which Lakusic et al. have considered. In our study, medications that were prescribed to patients were categorized to (i) directly affect lipid level (clofibrate, gemfibrazil, lovastatine, simvastatin, atrovasta-tin, nicotinic acid, and cholesteramin), (ii) indirectly affect lipid levels (glucocorticoids, thiazide, b-blocker, valproate and related drugs, garlic, estrogen and progesterone), and (iii) having no effect on lipids. It does not seem that the normal range of lipids has significant difference between our study and similar others. Moreover, publication bias in the literature is inevitable. It is obvious that journals usually tend to publish manuscripts with positive results. Therefore, more published papers with a positive effect of lipid-lowering medications do not necessarily prove the effectiveness of statins in increasing high-density lipoprotein (HDL) even after the deletion of the positive effect of exercise. We suggest a study of Hill’s criteria to show that statins definitely increase HDL. In addition, there are some differences between our study and that of Lakusic et al. Our program has been Comprehensive Cardiac Rehabilitation whereas their program has been Stationary Cardiac Rehabilitation. Sample size and duration of the studies were also different: 547 cases for 8 weeks (24 sessions) in our study versus 444 patients for 3 weeks (18 sessions). We should add difference in cultures, habits, exercise and nutritional status, activity level, alternative agents’ effect on lipid level such as some nutritional factors, compliance of the patients, adherence to treatment, proper use of the medications, etc. It is true that the difference in HDL levels is not significant in the group of patients who have received medication (group 1) but the statistical significance by itself is not important because the primary and final level of HDL in group 1 is higher than in patients without antilipid drugs (group 2). Therefore, this can explain why the differences in group 1 are not significant. Medication has had more efficiency in increasing HDL levels than exercise. In contrast, higher figures at baseline level may fail to show an increase later. Our baseline HDL cholesterol level was higher, which can be a reason for the difference between our study and that of Lakusic et al. However, we did a new analysis according to the baseline situation of cholesterol (normal vs. abnormal), end-of-treatment comparison, which did not show any changes in our results. When we considered statins as the only lipid-lowering medications, it showed significant effect in increasing HDL (mean standard error) in patients with high cholesterol at baseline (39.97 0.44 vs. 41 0.43, P1⁄4 0.029, N1⁄4403). But there was no significant diff","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HJR.0b013e3283386406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30089378","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":"In-patient cardiac rehabilitation versus medical care - a prospective multicentre controlled 12 months follow-up in patients with coronary heart disease.","authors":"Bernhard Schwaab,&nbsp;Annika Waldmann,&nbsp;Alexander Katalinic,&nbsp;Abdolhamid Sheikhzadeh,&nbsp;Heiner Raspe","doi":"10.1177/1741826710389392","DOIUrl":"https://doi.org/10.1177/1741826710389392","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate a 3-week inpatient cardiac rehabilitation (Rehab) started early after the index event in patients with coronary heart disease and evidence-based secondary preventive medication.</p><p><strong>Method: </strong>All patients had acute coronary angiography, 679 were discharged from hospital receiving usual care (Hosp), 795 completed a comprehensive Rehab. Follow-up was 12 months.</p><p><strong>Results: </strong>Rehab patients were older (64 vs. 62 years; p < 0.001), had more multivessel disease (51 vs. 37%; p < 0.001), heart failure (64 vs. 40%, p < 0.001), ST-segment elevation myocardial infarction (59 vs. 52%, p = 0.014), and renal insufficiency (10 vs. 7%, p = 0.036). Gender, peripheral artery disease, diabetes, hypertension, and socioeconomic status were similar in groups. Rehab patients had more beta-blockers (88 vs. 75%, p < 0.001) and angiotensin-converting enzyme inhibitors (81 vs. 70%, p < 0.001), a lower low-density lipoprotein cholesterol (102 vs. 122 mg/dl, p < 0.001), and a higher proportion of non-smokers (44 vs. 39%, p = 0.024). Primary combined endpoint of mortality, myocardial infarction (MI), revascularization, and hospitalization occurred in 32.6% of Rehab patients and in 38.7% of Hosp patients [p = 0.014; absolute risk reduction 0.0615, relative risk reduction 16%, number needed to treat (NNT) 17]. Myocardial infarction (MI) (1.8 vs. 3.8%, p = 0.015; NNT 49) and hospitalization (31.8 vs. 38.0%, p = 0.013; NNT 17) were reduced. In multivariate analysis, primary endpoint was reduced significantly (OR 0.729; 95% CI 0.585-0.909; p = 0.005) giving a relative risk reduction of 27% in favour of Rehab.</p><p><strong>Conclusion: </strong>Although Rehab patients were sicker at entry, their outcome was substantially improved within 12 months. With very low NNT, Rehab is highly effective and should be advised to all suitable patients with coronary heart disease.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389392","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29779582","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":"Angina pectoris: relation of epidemiological survey to registry data.","authors":"Tea Lallukka,&nbsp;Kristiina Manderbacka,&nbsp;Ilmo Keskimäki,&nbsp;Harry Hemingway,&nbsp;Ossi Rahkonen,&nbsp;Eero Lahelma,&nbsp;Reunanen Antti","doi":"10.1097/HJR.0b013e32833bfc73","DOIUrl":"https://doi.org/10.1097/HJR.0b013e32833bfc73","url":null,"abstract":"<p><strong>Background: </strong>Self-reported angina symptoms are collected in epidemiological surveys. We aimed at validating the angina symptoms assessed by the Rose Questionnaire against registry data on coronary heart disease. A further aim was to examine the sex paradox in angina implying that women report more symptoms, whereas men have more coronary events.</p><p><strong>Design: </strong>Angina symptoms of 6601 employees of the City of Helsinki were examined using the postal questionnaire survey data combined with coronary heart disease registries.</p><p><strong>Methods: </strong>The self-reported angina was classified as no symptoms, atypical pain, exertional chest pain, and stable angina symptoms. Reimbursed medications and hospital admissions were available from registries 10 years before the survey. Binomial regression analysis was used.</p><p><strong>Results: </strong>Stable angina symptoms were associated with hospital admissions and reimbursed medications [prevalence ratio (PR), 6.75; 95% confidence interval (CI), 4.56-9.99]. In addition, exertional chest pain (PR, 5.31; 95% CI, 3.45-8.18) was associated with coronary events. All events were more prevalent among men than women (PR, 2.36; 95% CI, 1.72-3.25).</p><p><strong>Conclusion: </strong>The Rose Questionnaire remains a valid tool to distinguish healthy people from those with coronary heart disease. However, a notable part of those reporting symptoms have no confirmation of coronary heart disease in the registries. The female excess of symptoms and male excess of events may reflect inequality or delay in access to treatment, problems in identification and diagnosis, or more complex issues related to self-reported angina symptoms.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HJR.0b013e32833bfc73","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780330","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":"Trans-fatty acids in New Zealand patients with coronary artery disease.","authors":"Jocelyne R Benatar,&nbsp;Patrick Gladding,&nbsp;Harvey D White,&nbsp;Irene Zeng,&nbsp;Ralph A H Stewart","doi":"10.1177/1741826710389415","DOIUrl":"https://doi.org/10.1177/1741826710389415","url":null,"abstract":"<p><strong>Background: </strong>Dietary surveys indicate that New Zealanders have a low intake of trans-fatty acids (TFA) with little derived from industrial sources. This observational cross-sectional study in New Zealand patients with surgical coronary artery disease assesses the plasma levels of TFA and the association of TFA levels with clinical markers of vascular disease.</p><p><strong>Methods: </strong>390 patients with severe coronary artery had fasting blood tests taken. Plasma levels of four TFA derived from hydrogenated vegetable oils and ruminant animal products were measured by gas chromatography. Relations between plasma TFA levels and the recent occurrence of myocardial infarction, the presence of polyvascular disease, and serum levels of C-reactive protein (CRP) were assessed.</p><p><strong>Results: </strong>The median TFA level was 0.85% by weight of total fatty acids (IQR 0.59-1.79%), with skewed distribution to the right. For the lowest (<0.74%), middle (0.74-1.07%), and highest (>1.07%) thirds of total TFA, respectively, the proportion of patients with polyvascular disease was 10%, 16%, and 27% (p = 0.0004). Plasma CRP also increased by tertile of TFA (median 2.0, 2.9, 3.2 mg/l, p = 0.007). The association with polyvascular diseases and CRP remained significant after adjustment for risk factors. Significant associations were present between plasma TFA from both ruminant and hydrogenated vegetable oil sources and these markers of cardiovascular risk.</p><p><strong>Conclusions: </strong>There is an association between relatively low plasma levels of total TFA, mostly derived from ruminant sources, and an increased risk of polyvascular disease and increased CRP in patients with severe coronary artery disease. These high-risk patients may benefit from a targeted approach to minimize all sources of TFA in the diet.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780666","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":"Coronary heart disease and cerebrovascular disease mortality in young adults: recent trends in Europe.","authors":"Paola Bertuccio,&nbsp;Fabio Levi,&nbsp;Francesca Lucchini,&nbsp;Liliane Chatenoud,&nbsp;Cristina Bosetti,&nbsp;Eva Negri,&nbsp;Carlo La Vecchia","doi":"10.1177/1741826710389393","DOIUrl":"https://doi.org/10.1177/1741826710389393","url":null,"abstract":"<p><strong>Background: </strong>Over the last two decades, mortality from coronary heart disease (CHD) and cerebrovascular disease (CVD) declined by about 30% in the European Union (EU).</p><p><strong>Design: </strong>We analyzed trends in CHD (X ICD codes: I20-I25) and CVD (X ICD codes: I60-I69) mortality in young adults (age 35-44 years) in the EU as a whole and in 12 selected European countries, over the period 1980-2007.</p><p><strong>Methods: </strong>Data were derived from the World Health Organization mortality database. With joinpoint regression analysis, we identified significant changes in trends and estimated average annual percent changes (AAPC).</p><p><strong>Results: </strong>CHD mortality rates at ages 35-44 years have decreased in both sexes since the 1980s for most countries, except for Russia (130/100,000 men and 24/100,000 women, in 2005-7). The lowest rates (around 9/100,000 men, 2/100,000 women) were in France, Italy and Sweden. In men, the steepest declines in mortality were in the Czech Republic (AAPC = -6.1%), the Netherlands (-5.2%), Poland (-4.5%), and England and Wales (-4.5%). Patterns were similar in women, though with appreciably lower rates. The AAPC in the EU was -3.3% for men (rate = 16.6/100,000 in 2005-7) and -2.1% for women (rate = 3.5/100,000). For CVD, Russian rates in 2005-7 were 40/100,000 men and 16/100,000 women, 5 to 10-fold higher than in most western European countries. The steepest declines were in the Czech Republic and Italy for men, in Sweden and the Czech Republic for women. The AAPC in the EU was -2.5% in both sexes, with steeper declines after the mid-late 1990s (rates = 6.4/100,000 men and 4.3/100,000 women in 2005-7).</p><p><strong>Conclusions: </strong>CHD and CVD mortality steadily declined in Europe, except in Russia, whose rates were 10 to 15-fold higher than those of France, Italy or Sweden. Hungary and Poland, and also Scotland, where CHD trends were less favourable than in other western European countries, also emerge as priorities for preventive interventions.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389393","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29840860","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":"Stepwise increase of angiopoietin-2 serum levels is related to haemodynamic and functional impairment in stable chronic heart failure.","authors":"Ermanno Eleuteri,&nbsp;Antonino Di Stefano,&nbsp;Franco Tarro Genta,&nbsp;Chiara Vicari,&nbsp;Isabella Gnemmi,&nbsp;Marilena Colombo,&nbsp;Alessandro Mezzani,&nbsp;Pantaleo Giannuzzi","doi":"10.1177/1741826710389410","DOIUrl":"https://doi.org/10.1177/1741826710389410","url":null,"abstract":"<p><strong>Background: </strong>A reciprocal link between inflammation, oxidative/nitrosative stress, and endothelial dysfunction has been postulated in chronic heart failure (CHF). The endothelial repair mechanisms involved remain to be determined. Our aim was to investigate whether there are detectable signs of ongoing angiogenesis in serum of CHF patients and to evaluate the correlation with indexes of haemodynamic and functional impairment.</p><p><strong>Methods and results: </strong>Enzyme-linked immunosorbent assay tests were used to quantify angiogenin, angiopoietin-1, angiopoietin-2, vascular endothelial growth factor, Tie-2, and brain natriuretic peptide in serum of 87 patients with CHF of increasing severity according to New York Heart Association (NYHA; class I, n = 8; II, n = 45; and III, n = 34) and in 14 healthy subjects matched for age and sex. Angiogenin, angiopoietin-2, and Tie-2 were significantly increased in CHF of increasing severity (Kruskal-Wallis: p = 0.0004, p < 0.0001, and p = 0.017, respectively). Angiopoietin-2 was inversely correlated with the 6-min walking test (r = -0.65, p < 0.0001), peak oxygen consumption (VO(2max); r = -0.57, p = 0.0002), and deceleration time (r = -0.61, p < 0.0001). Multiple regression analysis showed that angiopoietin-2 was mainly associated with VO(2max) (p = 0.018). The angiopoietin-2 area under the receiver operating characteristic curve for CHF diagnosis was 0.94 (95% CI 0.88-0.99; p < 0.001).</p><p><strong>Conclusions: </strong>These data demonstrate that angiopoietin-2 and selected serum markers of angiogenesis progressively increase with haemodynamic and functional decline in CHF.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780667","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":"Long-term predictors of smoking cessation in a cohort of myocardial infarction survivors: a longitudinal study.","authors":"Yariv Gerber,&nbsp;Nira Koren-Morag,&nbsp;Vicki Myers,&nbsp;Yael Benyamini,&nbsp;Uri Goldbourt,&nbsp;Yaacov Drory","doi":"10.1177/1741826710389371","DOIUrl":"https://doi.org/10.1177/1741826710389371","url":null,"abstract":"<p><strong>Background: </strong>Smoking has been causally linked to cardiovascular disease, and smoking cessation after myocardial infarction (MI) has been associated with a 50% reduction in mortality. Post-MI smokers are a vulnerable population for which efforts to encourage cessation should be maximized. We examined the determinants of smoking cessation after MI.</p><p><strong>Methods: </strong>A population-based cohort of 768 Israeli smokers was followed-up longitudinally after first MI. Data were collected at study entry on demographic, socioeconomic, smoking behaviour, and clinical variables. Psychosocial measures were obtained in a subsample (n = 330). Self-reported smoking status was assessed at 3-6 months, 1-2 years, 5 years, and 10-13 years after MI. Generalized estimating equation analyses determined which factors were significant predictors of smoking status.</p><p><strong>Results: </strong>Point abstinence rates throughout follow-up ranged from 55% to 70%, while continuous abstinence rates were 59% after 1-2 years, 44% after 5 years, and 35% after 10-13 years, among survivors. Variables most strongly associated with persistent smoking were young age, long duration and high intensity of pre-MI smoking, low education, poor family income, lack of a steady partner, non-diabetic status, and short hospital stay at the index MI. Significant psychosocial predictors were low sense of coherence and high depression.</p><p><strong>Conclusions: </strong>Determinants of smoking cessation after MI are multifactorial and include demographic, socioeconomic, smoking behaviour, clinical and psychosocial measures. Post-MI hospitalization is a window of opportunity for smoking cessation interventions. Patients should be assessed for psychosocial characteristics and those with low sense of coherence and high depression should be provided with targeted help to quit.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389371","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780012","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":"Self-reported physical inactivity predicts survival after hospitalization for heart disease.","authors":"Bodil Oerkild,&nbsp;Marianne Frederiksen,&nbsp;Jørgen Fischer Hansen,&nbsp;Eva Prescott","doi":"10.1177/1741826710389379","DOIUrl":"https://doi.org/10.1177/1741826710389379","url":null,"abstract":"<p><p>Physical inactivity increases with age and is shown to be inverse and independently related to mortality among patients with coronary heart disease. However, the knowledge of this relationship among elderly heart patients is limited because of their exclusion from many studies. The aim of this study was to investigate how self-reported physical activity affects all-cause mortality among elderly patients admitted to hospital with coronary heart disease or congestive heart failure. An observational study was carried out, including patients ≥65 years of age who were admitted to a Coronary Unit with coronary heart disease or congestive heart failure. Patients were asked to fill in a questionnaire on physical activity and divided into a sedentary and non-sedentary group, and followed for vital status for 2 ¹/₂; years after admission. In total, 150 patients participated. Within this study, all-cause mortality was 27.3%. Sedentary patients had a 3.9-fold (95% CI, 1.9 to 7.8) increase in mortality compared to non-sedentary patients. Adjusting for potential confounders such as severity of heart disease, co-morbidity, medication and social factors in a Cox proportional hazard regression model did not attenuate the association. Only 25% of sedentary patients with heart failure were alive after 2 ¹/₂; years compared to 75% of those that were physically active (p < 0.001). This study emphasises the importance of physical activity among elderly heart patients and demonstrates that a group of sedentary patients, who are at high risk, can easily be identified and require special attention.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780010","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":"Exercise training improves in vivo endothelial repair capacity of early endothelial progenitor cells in subjects with metabolic syndrome.","authors":"Kristina Sonnenschein,&nbsp;Tibor Horváth,&nbsp;Maja Mueller,&nbsp;Andrea Markowski,&nbsp;Tina Siegmund,&nbsp;Christian Jacob,&nbsp;Helmut Drexler,&nbsp;Ulf Landmesser","doi":"10.1177/1741826710389373","DOIUrl":"https://doi.org/10.1177/1741826710389373","url":null,"abstract":"<p><strong>Background: </strong>Endothelial dysfunction and injury are considered to contribute considerably to the development and progression of atherosclerosis. It has been suggested that intense exercise training can increase the number and angiogenic properties of early endothelial progenitor cells (EPCs). However, whether exercise training stimulates the capacity of early EPCs to promote repair of endothelial damage and potential underlying mechanisms remain to be determined. The present study was designed to evaluate the effects of moderate exercise training on in vivo endothelial repair capacity of early EPCs, and their nitric oxide and superoxide production as characterized by electron spin resonance spectroscopy analysis in subjects with metabolic syndrome.</p><p><strong>Methods and results: </strong>Twenty-four subjects with metabolic syndrome were randomized to an 8 weeks exercise training or a control group. Superoxide production and nitric oxide (NO) availability of early EPCs were characterized by using electron spin resonance (ESR) spectroscopy analysis. In vivo endothelial repair capacity of EPCs was examined by transplantation into nude mice with defined carotid endothelial injury. Endothelium-dependent, flow-mediated vasodilation was analysed using high-resolution ultrasound. Importantly, exercise training resulted in a substantially improved in vivo endothelial repair capacity of early EPCs (24.0 vs 12.7%; p < 0.05) and improved endothelium-dependent vasodilation. Nitric oxide production of EPCs was substantially increased after exercise training, but not in the control group. Moreover, exercise training reduced superoxide production of EPCs, which was not observed in the control group.</p><p><strong>Conclusions: </strong>The present study suggests for the first time that moderate exercise training increases nitric oxide production of early endothelial progenitor cells and reduces their superoxide production. Importantly, this is associated with a marked beneficial effect on the in vivo endothelial repair capacity of early EPCs in subjects with metabolic syndrome.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780011","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":"Gender disparities in the assessment and management of cardiovascular risk in primary care: the AusHEART study.","authors":"Fiona Turnbull,&nbsp;Hisatomi Arima,&nbsp;Emma Heeley,&nbsp;Alan Cass,&nbsp;John Chalmers,&nbsp;Claire Morgan,&nbsp;Anushka Patel,&nbsp;David Peiris,&nbsp;Andrew Weekes,&nbsp;Craig Anderson","doi":"10.1177/1741826710389369","DOIUrl":"https://doi.org/10.1177/1741826710389369","url":null,"abstract":"<p><strong>Aims: </strong>Studies indicate ongoing gender-based differences in the prevention, detection and management of cardiovascular disease. The aims of this study were to determine whether there are differences in general practitioners' (GPs') perceptions of a patient's cardiovascular risk compared with the patient's estimated risk and in the patient's subsequent medical management according to patient sex.</p><p><strong>Methods: </strong>The Australian Hypertension and Absolute Risk Study (AusHEART) was a nationally representative, cluster-stratified, cross-sectional survey among 322 GPs. Each GP was asked to collect data on cardiovascular disease risk factors and their management in 15-20 consecutive patients (age ≥55 years) who presented between April and June, 2008. They were also asked to estimate each patient's absolute risk of a cardiovascular event in the next five years. The main outcomes were the Adjusted Framingham risk, GP estimated risk and proportion of patients receiving blood pressure-lowering, statin and antiplatelet therapy.</p><p><strong>Results: </strong>A total of 5293 patients were recruited to the study, of whom 2968 (56%) were women. Among patients without established cardiovascular disease, the level of agreement between the GP estimated risk and the Adjusted Framingham risk was poor (<50%) and was similarly so for men (kappa coefficient 0.18; 95% confidence interval (CI) 0.14-0.21) and women (0.19; 95% CI 0.16-0.22; P homogeneity = 0.57). For patients with established cardiovascular disease, however, women were more likely to be assigned by the GP to a lower risk category (66% vs. 54%, P < 0.001) and less likely to be prescribed combination (blood pressure-lowering, statin and antiplatelet) (44% vs. 56%, P < 0.001) therapy compared with men, even after adjusting for patient age.</p><p><strong>Conclusions: </strong>Cardiovascular risk is underrecognized and undertreated in Australian primary care patients, with women apparently disproportionately affected. These findings underscore the importance of initiatives to raise awareness of cardiovascular disease in women.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29780013","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}