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Unveiling the burden of acute myocardial infarction deaths associated with COVID-19 during the first five years of the pandemic 揭示大流行头五年与COVID-19相关的急性心肌梗死死亡负担。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.02.004
Giuseppe Lippi , Carl J. Lavie , Fabian Sanchis Gomar
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引用次数: 0
Bridging the adherence gap in ASCVD: Aligning patient and provider perspectives on lipid-lowering therapy 弥合ASCVD的依从性差距:调整患者和提供者对降脂治疗的看法
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.04.011
Vita N. Jaspan , Michael D. Shapiro
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引用次数: 0
Treatment adherence patterns for patients with atherosclerotic cardiovascular disease: Patient and provider perspectives 动脉粥样硬化性心血管疾病患者的治疗依从性模式:患者和提供者的观点
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.06.004
Mary T. Imboden , Kyle G. Jones , Sarah E. Roth , Roxanne Marsillo , Laney K. Jones , Bethany Kalich , Eduard Sidelnikov , Ty J. Gluckman , Jennifer Rountree , Eleni Wilson , Staci J. Wendt
<div><h3>Background</h3><div>Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of mortality, affecting more than 500 million individuals globally. National guidelines recommend lipid-lowering therapies (LLTs) as first line agents for both primary and secondary prevention of ASCVD. However, under-prescribing of pharmacologic LLTs and sub-optimal medication adherence remain common problems.</div></div><div><h3>Aim</h3><div>This mixed-methods study aimed to identify patient and prescriber factors influencing adherence to LLTs.</div></div><div><h3>Methods</h3><div>Patients with an ASCVD diagnosis and treatment plan that included LLT were sampled from a large community health system serving seven states. A stratified random sample of 2500 patients was surveyed by mail, capturing barriers and facilitators to medication adherence using an adapted version of the Adherence Starts with Knowledge-12 (ASK-12) scale, achieving a 16.2 % response rate (406 patients). Twenty-three semi-structured interviews were conducted with a sample of patient survey respondents to further explore drivers of non-adherence. Eligible prescribers with experience treating patients with ASCVD were surveyed by email, resulting in a 3.3 % response rate (122 respondents). Survey data were analyzed descriptively and using regression models; interview data were analyzed thematically.</div></div><div><h3>Results</h3><div>While cohort patients were identified as having an ASCVD diagnosis and taking a LLT from their medical chart, only 16.8 % of respondents reported having an ASCVD diagnosis and 84.2 % reported taking LLTs. Patients taking medication reported a higher average number of health condition diagnoses compared to those not taking a medication (2.63 and 1.50, respectively). Of those taking medication, 55.7 % were identified as adherent. Non-adherent patients were more likely to report poor healthcare experiences and social determinants of health needs. Multivariable regression analysis revealed that patients were more likely to be adherent when they felt their healthcare provider always spent enough time with them and treated them with respect. Interview findings further emphasized the importance of healthcare experiences, convenience, and belief the treatment works as important factors to adherence. In contrast, prescribers perceived higher non-adherence rates, citing forgetfulness and medication inconvenience as the main barriers. However, only 10.0 % of responding prescribers reported using a tool to assess patients' medication adherence and only 42.6 % reported asking patients about changes to their medication regimens.</div></div><div><h3>Conclusion</h3><div>A substantial proportion of patients reported adherence to their medications, with adherence being associated with positive healthcare experiences, self-reported health conditions, perceived effectiveness of the medication, and social determinants of health needs. Prescribers perceived relatively low adh
背景:动脉粥样硬化性心血管疾病(ASCVD)是导致死亡的主要原因,影响全球超过5亿人。国家指南推荐降脂疗法(LLTs)作为ASCVD一级和二级预防的一线药物。然而,药理学llt的处方不足和次优药物依从性仍然是常见的问题。目的:本混合方法研究旨在确定影响llt依从性的患者和处方者因素。方法:从服务于7个州的大型社区卫生系统中抽样了ASCVD诊断和治疗计划包括LLT的患者。通过邮件对2500名患者进行分层随机抽样调查,使用改版的依从性始于知识-12 (ASK-12)量表捕获药物依从性的障碍和促进因素,达到16.2% %的应答率(406名患者)。23个半结构化访谈进行了抽样调查的患者受访者,以进一步探讨不依从性的驱动因素。通过电子邮件对具有治疗ASCVD患者经验的合格处方医师进行调查,得到3.3% %的应答率(122名应答者)。对调查数据进行描述性分析和回归模型分析;对访谈数据进行主题分析。结果:虽然队列患者被确定为患有ASCVD诊断并从其医疗图表中接受了LLT,但只有16.8% %的受访者报告患有ASCVD诊断,84.2 %的受访者报告接受了LLT。服用药物的患者报告的健康状况诊断的平均次数比未服用药物的患者高(分别为2.63和1.50)。在服用药物的患者中,55.7% %被确定为坚持治疗。非依从性患者更有可能报告不良的医疗保健经历和健康需求的社会决定因素。多变量回归分析显示,当患者感到他们的医疗保健提供者总是花足够的时间与他们在一起并尊重他们时,他们更有可能坚持治疗。访谈结果进一步强调了医疗体验、便利性和对治疗效果的信念作为坚持治疗的重要因素的重要性。相比之下,开处方者认为不遵医嘱的比例更高,理由是健忘和用药不便是主要障碍。然而,只有10.0% %的回应处方医生报告使用工具来评估患者的药物依从性,只有42.6% %的报告询问患者改变他们的药物治疗方案。结论:相当大比例的患者报告了他们的药物依从性,依从性与积极的医疗保健经历、自我报告的健康状况、药物的感知有效性和健康需求的社会决定因素有关。处方医生认为患者的依从性相对较低,但只有一小部分报告使用工具来评估药物依从性。综合评估工具和开放沟通可以优化患者护理,提高依从性和治疗效果。
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引用次数: 0
Cultural influences on choosing to move more and sit less 文化对选择多动少坐的影响。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.03.006
Rıdvan Aktan , Grenita Hall , Cemal Ozemek
Low levels of physical activity (PA) and prolonged periods of sedentary time significantly increase the risk of developing non-communicable diseases. Individuals who minimally increase their PA levels can experience significant reductions in risk of morbidity and mortality. Despite regular public messaging cycles and PA promotional campaigns highlighting these observations, the number of individuals meeting the PA recommendations has been underwhelming and stagnant for decades. Numerous studies have identified prominent barriers to becoming and staying physically active, in addition to a person's or people's cultural beliefs. Yet exercise professionals and other allied healthcare professionals may not consider one's cultural experiences when promoting PA. Recognizing the impact of culture on PA, whether it is positive or negative, can facilitate culturally sensitive discussions with individuals or groups and customizing PA recommendations in a way that facilitates its adoption. Accordingly, this paper aims to review relevant studies and examples of how culture can influence PA behaviors, as well as provide considerations for exercise professionals and allied healthcare providers to take when promoting PA in diverse populations.
低水平的身体活动(PA)和长时间久坐会显著增加患非传染性疾病的风险。个体最低限度地增加其PA水平可以显著降低发病率和死亡率的风险。尽管定期的公共信息传递周期和PA的宣传活动强调了这些观察结果,但几十年来,符合PA建议的个人数量一直没有给人留下深刻印象,并且停滞不前。除了个人或人们的文化信仰外,许多研究已经确定了成为和保持体育锻炼的主要障碍。然而,运动专业人士和其他相关医疗保健专业人士在推广PA时可能不会考虑一个人的文化经历。认识到文化对PA的影响,无论是积极的还是消极的,都可以促进与个人或团体进行文化敏感的讨论,并以一种促进其采用的方式定制PA建议。因此,本文旨在回顾文化如何影响PA行为的相关研究和例子,并为运动专业人员和相关医疗保健提供者在不同人群中推广PA提供考虑因素。
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引用次数: 0
The inclusion and consideration of cultural differences and health inequalities in physical activity behaviour in the UK - the impact of guidelines and initiatives 英国体育活动行为中包含和考虑文化差异和健康不平等——指导方针和倡议的影响。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.01.009
Mark A. Faghy , Jack Carr , David Broom , Gerri Mortimore , Vittoria Sorice , Rebecca Owen , Ross Arena , Ruth E.M. Ashton
Despite widespread attempts from governments and leading health organisations worldwide to promote equity in healthy living medicine, the evidence suggests that attempts to curb worsening public health have been almost entirely ineffective. Despite significant advancements in knowledge, medicine, and technology, as well as the promotion of guidelines and the implementation of numerous global initiatives aimed at addressing health disparities and mitigating the progression of non-communicable diseases (NCDs) worldwide, substantial work remains to be undertaken particularly in addressing inequalities in physical activity. Achieving equitable access to health resources and parity in health outcomes remains a critical and unresolved challenge. Whilst it is recognized that the public health paradigm is broad and complex, with many intersecting and interacting parts, the actions and considerations required to address the urgent and escalating scale of the problem appear at a crossroads of now or never. Throughout this narrative review, we describe the effectiveness of landmark physical activity-related guidelines, policies and national interventions that have been implemented since the turn of the century to address physical activity behaviour in the context of health inequalities.
尽管世界各地的政府和主要卫生组织都在努力促进健康生活医学的公平性,但有证据表明,遏制日益恶化的公共卫生状况的努力几乎完全无效。尽管在知识、医学和技术方面取得了重大进展,并促进了旨在解决健康差距和减缓世界范围内非传染性疾病进展的准则并实施了许多全球倡议,但仍有大量工作要做,特别是在解决身体活动不平等方面。实现卫生资源的公平获取和卫生成果的均等仍然是一项关键和未解决的挑战。虽然人们认识到公共卫生范式广泛而复杂,有许多相互交叉和相互作用的部分,但解决这一问题的紧迫性和不断升级的规模所需的行动和考虑似乎处于现在或永远的十字路口。在这篇叙述性综述中,我们描述了自世纪之交以来为解决健康不平等背景下的身体活动行为而实施的具有里程碑意义的身体活动相关指南、政策和国家干预措施的有效性。
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引用次数: 0
A social ecological perspective on interventions to address short sleep duration in adults with coronary heart disease 解决成人冠心病患者睡眠时间不足干预措施的社会生态学观点
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.05.003
Codie R. Rouleau , Sheila N. Garland

Background

Short sleep duration (<7 h/day) affects one-third of the population, is implicated in morbidity and mortality from coronary heart disease (CHD), and is driven by an interplay of individual, social, and societal factors.

Objective

To review observational and experimental studies that have tested interventions to address short sleep in various clinical presentations (sleep disorders, behaviorally induced short sleep, lack of sleep opportunity) and describe considerations needed for CHD populations.

Conclusions

Few existing interventions have a primary aim to increase sleep duration in individuals with insufficient sleep, and none specifically target individuals with established CHD. Short sleep duration may be modifiable via treatment of insomnia, behavioral sleep extension, and system-level changes to healthcare settings, workplace policies, and communities. With further research on interventions that address diverse phenotypes of short sleep—while assessing long-term cardiometabolic outcomes, patient preferences, and mechanisms-of-action—sleep health could become an important component of CHD secondary prevention.
背景:短睡眠时间(目的:回顾观察性和实验性研究,这些研究已经测试了干预措施,以解决各种临床表现(睡眠障碍,行为诱发的短睡眠,缺乏睡眠机会)的短睡眠问题,并描述了冠心病人群需要考虑的因素。结论:现有的干预措施很少以增加睡眠不足患者的睡眠时间为主要目的,也没有专门针对已确诊冠心病患者的干预措施。短睡眠时间可以通过治疗失眠、行为性睡眠延长以及医疗保健设置、工作场所政策和社区的系统级改变来改变。随着对不同短睡眠表型干预措施的进一步研究,同时评估长期心脏代谢结果、患者偏好和作用机制,睡眠健康可能成为冠心病二级预防的重要组成部分。
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引用次数: 0
Chronic psychological stress and cardiovascular disease risk: When to use single biomarkers versus allostatic load 慢性心理压力与心血管疾病风险:何时使用单一生物标志物与适应负荷
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.02.005
Aiden J. Chauntry , Anna C. Whittaker , Eli Puterman , Teresa Seeman , Megan Teychenne , Anne I. Turner , Gabriel Zieff , Jeongok G. Logan , Lee Stoner
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引用次数: 0
Artificial intelligence applied to ECG predicts mortality after a transcatheter aortic valve replacement 致编辑:应用于心电图的人工智能预测经导管主动脉瓣置换术后的死亡率。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.03.004
Ahmed K. Mahmoud , Juan M. Farina , Milagros Pereyra , Isabel G. Scalia , Niloofar Javadi , Donya Derakshani , Ali A. Elahi , Katie Mand , Mustafa Suppah , Mohammed Tiseer Abbas , Moaz A. Kamal , Kamal Awad , Chieh-Ju Chao , Vuyisile T. Nkomo , Said Alsidawi , Kwan S. Lee , Steven J. Lester , Kristen A. Sell-Dottin , David F. Fortuin , John P. Sweeney , Reza Arsanjani
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引用次数: 0
Knowing your audience: A narrative review of culturally tailored health programs for youth 了解你的受众:为青少年量身定制的文化健康计划的叙述回顾。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.02.002
Lindsey Strieter , Daniel Meyer , Sophia Kim
Health education is more effective when the providers/educators are knowledgeable about the population in which the education is being disseminated in and cognizant of the cultural influences on these areas of health. Simply put – “know your audience!” Because culture is who we are and what we are, it would be remis to ignore the richness of cultural foods, movement, and other health patterns. Embracing culture in its relationship to health is important. Health educators should be utilizing cultural variability and meeting the needs of specific populations. If lifestyle patterns are to be assimilated into daily practices, the behaviors must be meaningful and culturally relevant. When programs are tailored and implemented in youth and young adults, health education can take a proactive preventative role. This paper provides a perspective for approaching programming for youth, important components for tailoring educational programs, and a narrative review of educational health initiatives that seek to tailor their interventions towards youth. While programs do exist for youth, there is a need for improvement. If healthy living behaviors are to be assimilated into the cultural richness of the community in which the program is implemented, meeting the needs of youth through engaging relevant lessons is crucial.
如果提供者/教育者了解接受教育的人群,并认识到文化对这些健康领域的影响,健康教育就会更加有效。简单地说——“了解你的听众!”因为文化决定了我们是谁,我们是什么,所以忽视文化食物、运动和其他健康模式的丰富性是不明智的。接受文化与健康的关系是很重要的。健康教育工作者应利用文化差异,满足特定人群的需求。如果生活方式模式要融入日常实践,这些行为必须是有意义的和与文化相关的。当方案在青年和年轻成人中进行定制和实施时,健康教育可以发挥积极的预防作用。本文提供了一个接近青年规划的视角,定制教育计划的重要组成部分,以及对寻求定制其针对青年的干预措施的教育健康倡议的叙述回顾。虽然针对青少年的项目确实存在,但仍需要改进。如果要使健康的生活行为融入实施方案所在社区的丰富文化,就必须通过参加相关课程来满足青年的需要。
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引用次数: 0
The culture of healthy living – Exploring the chaos that drives health behaviors 健康生活的文化-探索驱动健康行为的混乱。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-05-01 DOI: 10.1016/j.pcad.2025.02.008
Ross Arena , Nicolaas P. Pronk , Colin Woodard
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引用次数: 0
期刊
Progress in cardiovascular diseases
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