Pub Date : 2010-06-01DOI: 10.1097/HJR.0b013e328331d2c3
Anne M Euser, Friedo W Dekker, Stein I Hallan
Background: The validity and appropriateness of the metabolic syndrome as a cardiovascular risk factor are increasingly debated, partly because of the lack of a unifying underlying pathophysiological mechanism. Intrauterine growth retardation (low birth weight by sex and gestational length) has been associated with several cardiovascular problems and could be an important underlying risk factor for the metabolic syndrome.
Methods: The association between intrauterine growth retardation (from the Norwegian Medical Birth Registry) and the metabolic syndrome in 7435 men and women aged 20-30 years from the population-based HUNT 2 study was studied with logistic regression using fractional polynomial models.
Results: In men, there were significant associations with several of the separate components of the metabolic syndrome: central obesity (exponential, P<0.001), raised triglycerides (negative linear, P = 0.018), reduced HDL-cholesterol (U-shaped, P = 0.086), raised blood pressure (negative linear, P = 0.036), and impaired glucose tolerance (negative linear, P = 0.036). In women, there were significant associations with central obesity (positive linear, P<0.001) and raised blood pressure (negative linear, P = 0.003) but not with the other components. When combining these components into the metabolic syndrome, an exponential association was found in men (P = 0.017), that is, increased risk in patients with high birth weight only. In women, there was no association at all (P = 0.959).
Conclusion: Low birth weight was not associated with the metabolic syndrome at young adult age. Several associations between birth weight and the separate components of the syndrome were found, however, but these associations were partly in different directions.
{"title":"Intrauterine growth restriction: no unifying risk factor for the metabolic syndrome in young adults.","authors":"Anne M Euser, Friedo W Dekker, Stein I Hallan","doi":"10.1097/HJR.0b013e328331d2c3","DOIUrl":"https://doi.org/10.1097/HJR.0b013e328331d2c3","url":null,"abstract":"<p><strong>Background: </strong>The validity and appropriateness of the metabolic syndrome as a cardiovascular risk factor are increasingly debated, partly because of the lack of a unifying underlying pathophysiological mechanism. Intrauterine growth retardation (low birth weight by sex and gestational length) has been associated with several cardiovascular problems and could be an important underlying risk factor for the metabolic syndrome.</p><p><strong>Methods: </strong>The association between intrauterine growth retardation (from the Norwegian Medical Birth Registry) and the metabolic syndrome in 7435 men and women aged 20-30 years from the population-based HUNT 2 study was studied with logistic regression using fractional polynomial models.</p><p><strong>Results: </strong>In men, there were significant associations with several of the separate components of the metabolic syndrome: central obesity (exponential, P<0.001), raised triglycerides (negative linear, P = 0.018), reduced HDL-cholesterol (U-shaped, P = 0.086), raised blood pressure (negative linear, P = 0.036), and impaired glucose tolerance (negative linear, P = 0.036). In women, there were significant associations with central obesity (positive linear, P<0.001) and raised blood pressure (negative linear, P = 0.003) but not with the other components. When combining these components into the metabolic syndrome, an exponential association was found in men (P = 0.017), that is, increased risk in patients with high birth weight only. In women, there was no association at all (P = 0.959).</p><p><strong>Conclusion: </strong>Low birth weight was not associated with the metabolic syndrome at young adult age. Several associations between birth weight and the separate components of the syndrome were found, however, but these associations were partly in different directions.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":" ","pages":"314-20"},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HJR.0b013e328331d2c3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40029767","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}
Pub Date : 2010-05-01DOI: 10.1177/17418267100170s213
PS Munk, UM Breland, P. Aukrust, T. Ueland, JT Kvaloy, AI Larsen, P. Blanc, C. Verkindt, S. Maunier, S. Chopra, F. Prieur, S. Kostic, D. Djordjevic, M. Rihter, V. Mitic, M. Lovic, D. Vulic, Tasic
P223 Clinical benefits of additional resistance-type exercises during endurance-based exercise intervention in coronary artery disease patients DRMJ Hansen, P Dendale, T Broekmans, M Roelants, A Daniels, K Hensen, JL Rummens, BO Eijnde Virga Jesse Hospital, Rehabilitation and Health Centre, Hasselt, Belgium, Rehabilitation & Health Care Research Centre, Dept. Health Care, PHL-University College, Hasselt, Belgium, Laboratory of Experimental Hematology, Virga Jesse Hospital, Hasselt, Belgium Topic: Cardiovascular rehabilitation Purpose: In the early rehabilitation of coronary artery disease (CAD) patients, resistance-type exercises are advocated in addition to endurance-type exercises. However, the clinical effects of these additional exercises remain to be explored. Methods: 55 CAD patients were included and randomly assigned to 6 weeks of endurance exercise training or combined endurance and resistance exercise training (mean 18 sessions). All subjects performed 3 exercises sessions/week at 65% of baseline VO2max, for 40 min/session. In the combined group, leg extension and leg squat exercise were additionally executed: 2 series, 12 up to 25 repetitions. Following parameters were evaluated: maximal exercise capacity and ventilatory threshold (ergospirometry test), body composition (dual x-ray absorptiometry scan), hematology, blood lipid profile and glycemic control, blood endothelial progenitor cell content, muscle strength (dynamometry test on Biodex), home-based habitual activity. Results: 42 CAD patients completed this intervention. In the combined-trained group upper leg lean tissue mass increased significantly (from 20.7 3.2 to 21.1 3.4kg, p<0.05), but not in the endurance-trained group (from 20.4 3.2 to 20.4 3.3kg, p>0.05). The significant improvement in blood haemoglobin content, hematocrit, VO2max, ventilatory threshold, and muscle isokinetic and endurance strength was similar between groups. The significant reduction in adipose tissue was equal between groups. In the combined-trained group, blood HDL cholesterol content increased significantly (from 40 10 to 45 10mg/dl, p<0.05), and white blood cell count decreased significantly (from 6.6 1.5 to 6.0 1.4 10(9), p<0.05), but not in the endurancetrained group (from 40 6 to 41 7mg/dl, and from 6.6 1.1 to 6.4 0.9 10(9), p>0.05). Conclusion: The addition of resistance-type exercises during an endurance exercise intervention in CAD results into a greater increase in blood HDL cholesterol content and decrease in white blood cell count. Therefore, cardiovascular disease risk could be reduced by greater magnitude in CAD patients when adding resistance-type exercises towards endurance-exercise intervention by a novel physiological mechanism.
P223冠状动脉疾病患者耐力运动干预期间额外阻力型运动的临床益处DRMJ Hansen, P Dendale, T Broekmans, M Roelants, A Daniels, K Hensen, JL Rummens, BO Eijnde Virga Jesse医院，康复与健康中心，哈瑟尔特，比利时，康复与卫生保健研究中心，ph -大学学院，哈瑟尔特，比利时，Virga Jesse医院，哈瑟尔特，实验血血学实验室，哈瑟尔特，Virga Jesse医院目的:在冠心病(CAD)患者的早期康复中，在耐力型锻炼的基础上，提倡阻力型锻炼。然而，这些额外锻炼的临床效果仍有待探索。方法:纳入55例CAD患者，随机分为6周耐力运动训练组或耐力与阻力联合训练组(平均18次)。所有受试者以65%的基线最大摄氧量/周进行3次运动，每次40分钟。在联合组中，腿部伸展和腿部深蹲运动额外进行:2个系列，12至25次重复。评估以下参数:最大运动能力和通气量阈值(肺活量测定试验)、身体组成(双x线吸收仪扫描)、血液学、血脂谱和血糖控制、血液内皮祖细胞含量、肌肉力量(Biodex上的动力测定试验)、家庭习惯性活动。结果:42例CAD患者完成了干预。联合训练组大鼠上肢瘦肉组织质量显著增加(由20.7 3.2 kg增加至21.1 3.4kg, p0.05)。血红蛋白含量、红细胞压积、最大摄氧量、通气阈值、肌肉等速运动和耐力强度的显著改善在两组之间相似。脂肪组织的显著减少在两组之间相等。在联合训练组，血液中高密度脂蛋白胆固醇含量显著增加(从4010到4510mg /dl, p0.05)。结论:在CAD耐力运动干预中加入阻力型运动可导致血液中高密度脂蛋白胆固醇含量的增加和白细胞计数的降低。因此，通过一种新的生理机制，将阻力型运动加入到耐力运动干预中，可以更大程度地降低冠心病患者的心血管疾病风险。
{"title":"Poster Session II: Cardiac rehabilitation","authors":"PS Munk, UM Breland, P. Aukrust, T. Ueland, JT Kvaloy, AI Larsen, P. Blanc, C. Verkindt, S. Maunier, S. Chopra, F. Prieur, S. Kostic, D. Djordjevic, M. Rihter, V. Mitic, M. Lovic, D. Vulic, Tasic","doi":"10.1177/17418267100170s213","DOIUrl":"https://doi.org/10.1177/17418267100170s213","url":null,"abstract":"P223 Clinical benefits of additional resistance-type exercises during endurance-based exercise intervention in coronary artery disease patients DRMJ Hansen, P Dendale, T Broekmans, M Roelants, A Daniels, K Hensen, JL Rummens, BO Eijnde Virga Jesse Hospital, Rehabilitation and Health Centre, Hasselt, Belgium, Rehabilitation & Health Care Research Centre, Dept. Health Care, PHL-University College, Hasselt, Belgium, Laboratory of Experimental Hematology, Virga Jesse Hospital, Hasselt, Belgium Topic: Cardiovascular rehabilitation Purpose: In the early rehabilitation of coronary artery disease (CAD) patients, resistance-type exercises are advocated in addition to endurance-type exercises. However, the clinical effects of these additional exercises remain to be explored. Methods: 55 CAD patients were included and randomly assigned to 6 weeks of endurance exercise training or combined endurance and resistance exercise training (mean 18 sessions). All subjects performed 3 exercises sessions/week at 65% of baseline VO2max, for 40 min/session. In the combined group, leg extension and leg squat exercise were additionally executed: 2 series, 12 up to 25 repetitions. Following parameters were evaluated: maximal exercise capacity and ventilatory threshold (ergospirometry test), body composition (dual x-ray absorptiometry scan), hematology, blood lipid profile and glycemic control, blood endothelial progenitor cell content, muscle strength (dynamometry test on Biodex), home-based habitual activity. Results: 42 CAD patients completed this intervention. In the combined-trained group upper leg lean tissue mass increased significantly (from 20.7 3.2 to 21.1 3.4kg, p<0.05), but not in the endurance-trained group (from 20.4 3.2 to 20.4 3.3kg, p>0.05). The significant improvement in blood haemoglobin content, hematocrit, VO2max, ventilatory threshold, and muscle isokinetic and endurance strength was similar between groups. The significant reduction in adipose tissue was equal between groups. In the combined-trained group, blood HDL cholesterol content increased significantly (from 40 10 to 45 10mg/dl, p<0.05), and white blood cell count decreased significantly (from 6.6 1.5 to 6.0 1.4 10(9), p<0.05), but not in the endurancetrained group (from 40 6 to 41 7mg/dl, and from 6.6 1.1 to 6.4 0.9 10(9), p>0.05). Conclusion: The addition of resistance-type exercises during an endurance exercise intervention in CAD results into a greater increase in blood HDL cholesterol content and decrease in white blood cell count. Therefore, cardiovascular disease risk could be reduced by greater magnitude in CAD patients when adding resistance-type exercises towards endurance-exercise intervention by a novel physiological mechanism.","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"17 1","pages":"S47 - S50"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/17418267100170s213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65490954","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}
Pub Date : 2010-05-01DOI: 10.1177/17418267100170s221
S. Basavarajaiah, J. Rawlins, NChandra, LCarby, E. Sawyer, S. Sharma, E. Tataradze, Z. Sopromadze, N. Chabashvili, E. Chumburidze, Buleishvili
P307 Relationship between exercise related blood pressure response and differences in magnitude of left venticular hypertrophy between african/afro-carribean (black) athletes and caucasian athletes SGati,MPapadakis, S Basavarajaiah, J Rawlins, NChandra, LCarby, E Sawyer, S Sharma Univeristy Hospital Lewisham, London, United Kingdom, King’s College Hospital, London, United Kingdom Topic: Sports cardiology Purpose: Participation in regular physical exercise is associated with a greater magnitude of left ventricular hypertrophy in male athletes of African/Afro-Caribbean origin (black athletes) compared with athletes of Caucasian origin of similar age and size, participating in similar exercise disciplines. The precise genetic, biochemical and physiological mechanisms for these differences is unknown. However, the role of exercise related blood pressure response as a determinant of exercise induced left ventricular hypertrophy has not been tested. Aim: The study sought to investigate whether there were differences in exercise related blood pressure response in black athletes and Caucasian athletes. Method: Between 2004 and 2007, 300 black athletes and 300 white athletes (mean age 20 5 years) participating at regional or national level underwent echocardiographic evaluation. Of these 54 black athletes (18%) and 12 white athletes (4%) exhibited a LV wall thickness>12mm indicating LVH. Black and Caucasian athletes with left ventricular hypertrophy of >12mm were subject to exercise stress testing with simultaneous blood pressure recording using the Bruce protocol. All athletes were exercised to the point of volitional exhaustion. Results: Black athletes exhibited a greater mean left ventricular wall thickness compared with white athletes (11.3 1mm; range 13-16mm v. 10 1.5mm; range 13-14mm: p<0.0001). The blood pressure responses to exercise are tabulated below (Table 1). There were no significant differences in blood pressure response to exercise when comparing black athletes and white athletes. Conclusion:The greater magnitude of left ventricular hypertrophy in blacks is not explained by a difference in exercise related blood pressure response
P307非洲/非洲-加勒比(黑人)运动员与白人运动员运动相关血压反应与左心室肥大程度差异的关系sgari,MPapadakis, S Basavarajaiah, J Rawlins, NChandra, LCarby, E Sawyer, S Sharma大学医院，英国伦敦，Lewisham，英国伦敦，国王学院医院，英国主题:运动心脏病学与年龄和体型相近、参加类似运动项目的白人运动员相比，参加定期体育锻炼的非洲/非洲-加勒比裔男性运动员(黑人运动员)左心室肥厚的程度更大。这些差异的确切遗传、生化和生理机制尚不清楚。然而，运动相关血压反应作为运动诱导左心室肥厚的决定因素的作用尚未得到验证。目的:本研究旨在调查黑人运动员和白人运动员在运动相关血压反应方面是否存在差异。方法:2004 ~ 2007年，对300名黑人运动员和300名白人运动员(平均年龄20 ~ 5岁)进行超声心动图评价。54名黑人运动员(18%)和12名白人运动员(4%)的左室壁厚度为bbb12mm，表明LVH。黑人和白人左心室肥厚12mm的运动员进行运动应激测试，同时使用Bruce方案记录血压。所有的运动员都被锻炼到意志疲惫的地步。结果:黑人运动员比白人运动员表现出更大的平均左心室壁厚度(11.3 mm;量程13-16mm v. 10 1.5mm;范围13-14mm: p<0.0001)。运动后的血压反应见下表(表1)。黑人运动员和白人运动员在运动后的血压反应没有显著差异。结论:黑人左心室肥厚的程度更大，不能用运动相关血压反应的差异来解释
{"title":"Moderated Poster Session V: Sports cardiology","authors":"S. Basavarajaiah, J. Rawlins, NChandra, LCarby, E. Sawyer, S. Sharma, E. Tataradze, Z. Sopromadze, N. Chabashvili, E. Chumburidze, Buleishvili","doi":"10.1177/17418267100170s221","DOIUrl":"https://doi.org/10.1177/17418267100170s221","url":null,"abstract":"P307 Relationship between exercise related blood pressure response and differences in magnitude of left venticular hypertrophy between african/afro-carribean (black) athletes and caucasian athletes SGati,MPapadakis, S Basavarajaiah, J Rawlins, NChandra, LCarby, E Sawyer, S Sharma Univeristy Hospital Lewisham, London, United Kingdom, King’s College Hospital, London, United Kingdom Topic: Sports cardiology Purpose: Participation in regular physical exercise is associated with a greater magnitude of left ventricular hypertrophy in male athletes of African/Afro-Caribbean origin (black athletes) compared with athletes of Caucasian origin of similar age and size, participating in similar exercise disciplines. The precise genetic, biochemical and physiological mechanisms for these differences is unknown. However, the role of exercise related blood pressure response as a determinant of exercise induced left ventricular hypertrophy has not been tested. Aim: The study sought to investigate whether there were differences in exercise related blood pressure response in black athletes and Caucasian athletes. Method: Between 2004 and 2007, 300 black athletes and 300 white athletes (mean age 20 5 years) participating at regional or national level underwent echocardiographic evaluation. Of these 54 black athletes (18%) and 12 white athletes (4%) exhibited a LV wall thickness>12mm indicating LVH. Black and Caucasian athletes with left ventricular hypertrophy of >12mm were subject to exercise stress testing with simultaneous blood pressure recording using the Bruce protocol. All athletes were exercised to the point of volitional exhaustion. Results: Black athletes exhibited a greater mean left ventricular wall thickness compared with white athletes (11.3 1mm; range 13-16mm v. 10 1.5mm; range 13-14mm: p<0.0001). The blood pressure responses to exercise are tabulated below (Table 1). There were no significant differences in blood pressure response to exercise when comparing black athletes and white athletes. Conclusion:The greater magnitude of left ventricular hypertrophy in blacks is not explained by a difference in exercise related blood pressure response","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"328 1","pages":"S65 - S66"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/17418267100170s221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65491394","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}
Pub Date : 2010-05-01DOI: 10.1177/17418267100170s224
C. Guijarro, E. Alegrı́a, J. Lozano, B. González-Timón, Gomez-Salinas, G. Vitale, J. Millán, E. Gomez-Salinas, BGonzalez-Timon, J. González-Juanatey, M. Lejsková, P. Stavek, S. Zecova, J. Kunišek, L. Zaputović, Z. Čubranić, L. Kunišek, V. Peršić, A. Ružić, M. Žuvić, Butorac, S. V. Rapaić
P346 Adherence with statins in a real-life setting is better when cardiovascular risk factors increase T Couffinhal, P Latry, M Molimar, B Begaud, M Lafitte, K Martin-Latry University Hospital of Bordeaux Hospital Haut Leveque, Departement of Cardiology, Pessac, France, Direction Regionale du Service Medical de l’Assurance Maladie d’Aquitaine, CNAMTS, Bordeaux, France, Inserm U 657, Universite Victor Segalen Bordeaux 2, Bordeaux, France Topic: Pharmacoepidemiology Background: Several studies have shown poor adherence to statin treatments and several associated factors have been highlighted: younger age, insufficient revenue, absence of cardiovascular morbidity, women, number of coprescribed drugs. While the factors for poor adherence have been highlighted, the impact of their combination on adherence is not clear. Purpose: To estimate adherence for statins and whether it differs according to the number of cardiovascular risk factors. Methods: A cohort study was conducted using data from the French social security insurance database. Patients were included if they submitted a reimbursement form for a prescription for statins between September 1 and December 31, 2004, and did not receive any statin treatment for 6 months previous to this. Patients were followed up 15 months. Statin use was considered a proxy for hypercholesterolemia. The cohort was split into three groups according to their number of additional cardiovascular risk factors that included age and gender, diabetes mellitus and cardiovascular disease (using co-medications as a proxy). Adherence was assessed for each group by using four parameters: (i) proportion of days covered by statins, (ii) regularity of the treatment over time, (iii) persistence, and (iv) the patient s understanding of the treatment. Results: 16,397 newly treated patients were identified. Of these statin users, 21.7 % did not have additional cardiovascular risk factors. Thirty-one percent had two cardiovascular risk factor and 47% had at least three risk factors. All the parameters showed a sub-optimal adherence whatever the group: days covered ranged from 56 % to 72 %, regularity ranged from 23 % to 33 % and persistence ranged from 44 % to 59 %, but adherence was better for those with a higher number of cardiovascular risk factors. Conclusions: The results confirm that long-term drug treatments are a difficult challenge, particularly in patients at lower risk.
P346当心血管危险因素增加时，现实生活中他汀类药物的依从性更好T Couffinhal, P Latry, M Molimar, B Begaud, M Lafitte, K Martin-Latry University Hospital of Bordeaux Hospital Haut Leveque，心内科，Pessac，法国，波尔多，CNAMTS，法国，波尔多，Inserm U 657, Universite Victor Segalen Bordeaux 2，法国几项研究表明他汀类药物治疗依从性差，并强调了几个相关因素:年轻、收入不足、没有心血管发病率、女性、处方药物数量。虽然强调了不良依从性的因素，但其组合对依从性的影响尚不清楚。目的:评估他汀类药物的依从性，以及它是否因心血管危险因素的数量而有所不同。方法:采用法国社会保障数据库中的数据进行队列研究。如果患者在2004年9月1日至12月31日期间提交了他汀类药物处方报销表格，并且在此之前6个月内未接受任何他汀类药物治疗，则纳入研究。随访15个月。他汀类药物的使用被认为是高胆固醇血症的代表。根据他们的额外心血管风险因素的数量，包括年龄和性别，糖尿病和心血管疾病(使用联合药物作为代理)，将队列分为三组。通过使用四个参数来评估每组的依从性:(i)他汀类药物覆盖的天数比例，(ii)治疗随时间的规律性，(iii)持久性，以及(iv)患者对治疗的理解。结果:新诊患者16397例。在这些他汀类药物使用者中，21.7%没有额外的心血管危险因素。31%的人有两种心血管风险因素，47%的人至少有三种风险因素。所有参数都显示，无论在哪个组，依从性都不是最佳的:覆盖的天数从56%到72%不等，规律性从23%到33%不等，持久性从44%到59%不等，但对于心血管危险因素较多的患者，依从性更好。结论:结果证实，长期药物治疗是一项艰巨的挑战，特别是在低风险患者中。
{"title":"Poster Session III: Epidemiology and public health","authors":"C. Guijarro, E. Alegrı́a, J. Lozano, B. González-Timón, Gomez-Salinas, G. Vitale, J. Millán, E. Gomez-Salinas, BGonzalez-Timon, J. González-Juanatey, M. Lejsková, P. Stavek, S. Zecova, J. Kunišek, L. Zaputović, Z. Čubranić, L. Kunišek, V. Peršić, A. Ružić, M. Žuvić, Butorac, S. V. Rapaić","doi":"10.1177/17418267100170s224","DOIUrl":"https://doi.org/10.1177/17418267100170s224","url":null,"abstract":"P346 Adherence with statins in a real-life setting is better when cardiovascular risk factors increase T Couffinhal, P Latry, M Molimar, B Begaud, M Lafitte, K Martin-Latry University Hospital of Bordeaux Hospital Haut Leveque, Departement of Cardiology, Pessac, France, Direction Regionale du Service Medical de l’Assurance Maladie d’Aquitaine, CNAMTS, Bordeaux, France, Inserm U 657, Universite Victor Segalen Bordeaux 2, Bordeaux, France Topic: Pharmacoepidemiology Background: Several studies have shown poor adherence to statin treatments and several associated factors have been highlighted: younger age, insufficient revenue, absence of cardiovascular morbidity, women, number of coprescribed drugs. While the factors for poor adherence have been highlighted, the impact of their combination on adherence is not clear. Purpose: To estimate adherence for statins and whether it differs according to the number of cardiovascular risk factors. Methods: A cohort study was conducted using data from the French social security insurance database. Patients were included if they submitted a reimbursement form for a prescription for statins between September 1 and December 31, 2004, and did not receive any statin treatment for 6 months previous to this. Patients were followed up 15 months. Statin use was considered a proxy for hypercholesterolemia. The cohort was split into three groups according to their number of additional cardiovascular risk factors that included age and gender, diabetes mellitus and cardiovascular disease (using co-medications as a proxy). Adherence was assessed for each group by using four parameters: (i) proportion of days covered by statins, (ii) regularity of the treatment over time, (iii) persistence, and (iv) the patient s understanding of the treatment. Results: 16,397 newly treated patients were identified. Of these statin users, 21.7 % did not have additional cardiovascular risk factors. Thirty-one percent had two cardiovascular risk factor and 47% had at least three risk factors. All the parameters showed a sub-optimal adherence whatever the group: days covered ranged from 56 % to 72 %, regularity ranged from 23 % to 33 % and persistence ranged from 44 % to 59 %, but adherence was better for those with a higher number of cardiovascular risk factors. Conclusions: The results confirm that long-term drug treatments are a difficult challenge, particularly in patients at lower risk.","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"17 1","pages":"S75 - S82"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/17418267100170s224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65491489","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}
Pub Date : 2010-05-01DOI: 10.1177/17418267100170s216
I. Osipova, O. Antropova, A. Zalzman, N. Lobanova, K. Golovina, C. Langer, S. Regenzuck, F. Buuren, K.-P. Mellwig, C. Beller, M. Vlachojannis, Fruend, D. Horstkotte, T. Suvorava
P252 Peculiarities of left ventricular remodeling in subjects with masking arterial hypertension I Osipova, O Antropova, A Zalzman, N Lobanova, K Golovina Altay State Medical University, Barnaul, Russian Federation, Departmental Clinical Hospital, Barnaul, Russian Federation Topic: Early detection of asymptomatic disease The purpose of the study was to estimate target-organs condition in patients with masking (isolated ambulatory) hypertension having operator professions. 329 males were included in the study. According to blood pressure monitoring during working and rest hours the subjects were distributed into 2 groups. 197 patients with masking arterial hypertension at working place formed the 1st group, 132 males with low-stress work and essential hypertension formed the second group. All subjects were performed echocardiography, duplex scanning of brachiocephal arteries. In comparison with 2nd group subjects, 1st group subjects had lower early diastolic filling rate (peak E) over 9.5% (pU0,001) and higher late diastolic filling rate (peak A) over 19.1% (pU0,001), less ratio E/A over 33.3% (pU0,001).Type I diastolic dysfunction was revealed in 147 (74.6%) and 79 (59.8%) subjects of the 1st and 2nd groups correspondingly, that is over 14.8% (XU8.0, pU0,005) more frequent in males with masking arterial hypertension. Left ventricular (LV) hypertrophy was revealed in 75 (38.1%) and 37 (28.1%) subjects of 1 and 2 group correspondingly, thus its frequency was comparable. In 1st group subjects normal LV geometry was detected in 72 (36.5%) subjects, concentric remodeling in 50 (25.4%) subjects, concentric LV hypertrophy 48 (24.4%) subjects, eccentric LV hypertrophy was detected in 27 (13.7%) subjects. In 2nd group subjects normal LV geometry was detected in 59 (44.7%) subjects, concentric remodeling in 36 (27.3%) subjects, concentric LV hypertrophy 16 (12.1%) subjects, eccentric LV hypertrophy was detected in 12.3% subjects (XU7.9; pU0.05). Consequently, in comparison with patients with essential hypertension the patients with masking arterial hypertension have more frequent LV diastolic dysfunction, comparable frequency of LV hypertrophy but its more adverse concentric type.
P252隐匿性动脉高血压患者左心室重塑的特点I Osipova, O Antropova, A Zalzman, N Lobanova, K Golovina阿勒泰国立医科大学，俄罗斯联邦巴尔努尔，部门临床医院，俄罗斯联邦巴尔努尔主题:无症状疾病的早期发现本研究的目的是评估具有操作人员职业的隐匿性(孤立的门诊)高血压患者的靶器官状况。329名男性参与了这项研究。根据工作和休息时的血压监测将受试者分为两组。第一组为197例工作场所隐匿性动脉高血压患者，第二组为132例男性低压力工作伴原发性高血压患者。所有受试者均行超声心动图，双联扫描头臂动脉。与第二组比较，第一组患者舒张早期充盈率(峰值E)低9.5%以上(pu001)，舒张晚期充盈率(峰值A)高19.1%以上(pu001)， E/A比低33.3%以上(pu001)。ⅰ型舒张功能障碍发生率分别为147例(74.6%)和79例(59.8%)，其中隐匿性高血压男性发生率高14.8% (XU8.0, pu0.005)。1组和2组分别有75例(38.1%)和37例(28.1%)出现左室肥厚，其发生率具有可比性。第一组正常左室几何72例(36.5%)，同心圆重构50例(25.4%)，同心圆左室肥厚48例(24.4%)，偏心左室肥厚27例(13.7%)。第二组正常左室59例(44.7%)，同心圆重构36例(27.3%)，同心圆左室肥厚16例(12.1%)，偏心性左室肥厚12.3% (XU7.9;pU0.05)。因此，与原发性高血压患者相比，隐蔽性动脉高血压患者的左室舒张功能障碍发生率更高，左室肥厚发生率相当，但其不利的同心型发生率更高。
{"title":"Poster Session II: Basic science: cardiovascular physiology","authors":"I. Osipova, O. Antropova, A. Zalzman, N. Lobanova, K. Golovina, C. Langer, S. Regenzuck, F. Buuren, K.-P. Mellwig, C. Beller, M. Vlachojannis, Fruend, D. Horstkotte, T. Suvorava","doi":"10.1177/17418267100170s216","DOIUrl":"https://doi.org/10.1177/17418267100170s216","url":null,"abstract":"P252 Peculiarities of left ventricular remodeling in subjects with masking arterial hypertension I Osipova, O Antropova, A Zalzman, N Lobanova, K Golovina Altay State Medical University, Barnaul, Russian Federation, Departmental Clinical Hospital, Barnaul, Russian Federation Topic: Early detection of asymptomatic disease The purpose of the study was to estimate target-organs condition in patients with masking (isolated ambulatory) hypertension having operator professions. 329 males were included in the study. According to blood pressure monitoring during working and rest hours the subjects were distributed into 2 groups. 197 patients with masking arterial hypertension at working place formed the 1st group, 132 males with low-stress work and essential hypertension formed the second group. All subjects were performed echocardiography, duplex scanning of brachiocephal arteries. In comparison with 2nd group subjects, 1st group subjects had lower early diastolic filling rate (peak E) over 9.5% (pU0,001) and higher late diastolic filling rate (peak A) over 19.1% (pU0,001), less ratio E/A over 33.3% (pU0,001).Type I diastolic dysfunction was revealed in 147 (74.6%) and 79 (59.8%) subjects of the 1st and 2nd groups correspondingly, that is over 14.8% (XU8.0, pU0,005) more frequent in males with masking arterial hypertension. Left ventricular (LV) hypertrophy was revealed in 75 (38.1%) and 37 (28.1%) subjects of 1 and 2 group correspondingly, thus its frequency was comparable. In 1st group subjects normal LV geometry was detected in 72 (36.5%) subjects, concentric remodeling in 50 (25.4%) subjects, concentric LV hypertrophy 48 (24.4%) subjects, eccentric LV hypertrophy was detected in 27 (13.7%) subjects. In 2nd group subjects normal LV geometry was detected in 59 (44.7%) subjects, concentric remodeling in 36 (27.3%) subjects, concentric LV hypertrophy 16 (12.1%) subjects, eccentric LV hypertrophy was detected in 12.3% subjects (XU7.9; pU0.05). Consequently, in comparison with patients with essential hypertension the patients with masking arterial hypertension have more frequent LV diastolic dysfunction, comparable frequency of LV hypertrophy but its more adverse concentric type.","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"17 1","pages":"S55 - S56"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/17418267100170s216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65491686","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}
Pub Date : 2010-05-01DOI: 10.1177/17418267100170s210
G. Fazio, S. Milia, I. Brusca, S. Paterna, G. Novo, S. Novo, P. Di, Pasquale, G. G. VeigaGuimaraes, Jfc Belli, LN Pascoalino, V. Carvalho, VS Issa, Lgb Cruz, E. Bocchi, J. Neder
P160 Determinants and prognostic value of the VE/VCO2 slope as compared to neurohormonal activation in elderly patients with CAD and preserved LV function J H A J De Sutter, N Van De Veire, J Philippe, M De Buyzere Ghent University, Ghent, Belgium Topic: Biomarkers Background and study aims:The VE/CO2 slope is considered as a powerful predictor of cardiac events in patients with heart failure. In this study we evaluated the determinants and prognostic value of the VE/VCO2 slope in the ever increasing population of elderly patients with CAD and preserved LV function. We also compared the predictive value of the VE/CO2 slope with NTproBNP as marker of neurohormonal activation. Methods:We studied 89 patients 70 years or older (mean age 75 4 years, 85% men) with CAD and LVEF = 50% (mean LVEF 64 9 %). All patients underwent a maximal bicycle spiroergometry for the evaluation of VO2max and the VE/CO2 slope. Serum NT-proBNP, creatinine and high sensitivity CRP were determined. Echocardiography was performed to evaluate E/E as marker of LV filling pressures. Patients were followed for a median follow-up of 32months for the combined end-point of mortality, AMI, PCI, CABG or hospitalisation for heart failure. Results:Mean VO2max was 15,5 4,1 ml/kg/min andmean VE/CO2 slope was 32 6. Tertiles of VE/CO2 slope were associated with higher levels of NT-proBNP, hsCRP and E/E (all p-values < 0.05) but not with age, VO2max or creatinine levels. Patients with events during follow-up (n1⁄416) had higher values of VE/CO2 slope, NT-proBNP and creatinine but no differences were noted for age, VO2max, hsCRP and E/E . ROC analysis showed AUC values of 0,74 (95%CI 0,59-0,89, p<0.01) for NT-proBNP and 0,67 (95% CI 0,53-0,81, p<0.05) for VE/CO2 slope. In multivariate Cox regression analysis, VE/CO2 slope appeared as an independent predictor (p<0.05) for cardiac events. However, after introduction of NT-proBNP in the model, VE/CO2 did not remain as predictor, in contrast to NT-proBNP (p<0.01). Conclusions: In elderly patients with CAD and preserved LV function, increased levels of VE/ VCO2 slope are related to higher LV filling pressures as well as higher levels of parameters of neurohormonal and inflammatory activation. Although the VE/CO2 slope is a predictor of cardiac events, its predictive power is weaker as compared to NT-proBNP.
P160与神经激素激活相比，老年CAD和左室功能保留患者VE/VCO2斜率的决定因素和预后价值[H] A J De Sutter, N Van De Veire, J Philippe, M De Buyzere，根特大学，比利时主题:生物标志物背景和研究目的:VE/CO2斜率被认为是心衰患者心脏事件的有力预测因子。在这项研究中，我们评估了不断增加的老年冠心病患者和左室功能保留患者的VE/VCO2斜率的决定因素和预后价值。我们还比较了VE/CO2斜率与NTproBNP作为神经激素激活标志物的预测值。方法:我们研究了89例70岁及以上的冠心病患者(平均75.4岁，85%为男性)，LVEF = 50%(平均LVEF为64.9%)。所有患者都进行了最大自行车肺活量测定，以评估VO2max和VE/CO2斜率。检测血清NT-proBNP、肌酐、高敏CRP。超声心动图评价E/E作为左室充盈压的标志。患者的中位随访时间为32个月，以死亡率、AMI、PCI、CABG或心力衰竭住院为综合终点。结果:平均VO2max为15、5、1 ml/kg/min，平均VE/CO2斜率为326。VE/CO2斜率的分位数与NT-proBNP、hsCRP和E/E水平升高相关(p值均< 0.05)，但与年龄、VO2max或肌酐水平无关。随访期间发生事件的患者(n1 / 416)的VE/CO2斜率、NT-proBNP和肌酐值较高，但年龄、VO2max、hsCRP和E/E没有差异。ROC分析显示NT-proBNP的AUC值为0.74 (95%CI为0.59 ~ 0.89,p<0.01)， VE/CO2斜率的AUC值为0.67 (95%CI为0.53 ~ 0.81,p<0.05)。在多变量Cox回归分析中，VE/CO2斜率出现为心脏事件的独立预测因子(p<0.05)。然而，在模型中引入NT-proBNP后，与NT-proBNP相比，VE/CO2不再是预测因子(p<0.01)。结论:老年冠心病患者左室功能保留时，VE/ VCO2斜率升高与左室充血压力升高、神经激素参数升高和炎症激活升高有关。虽然VE/CO2斜率是心脏事件的预测因子，但与NT-proBNP相比，其预测能力较弱。
{"title":"Moderated Poster Session IV: Exercise physiology","authors":"G. Fazio, S. Milia, I. Brusca, S. Paterna, G. Novo, S. Novo, P. Di, Pasquale, G. G. VeigaGuimaraes, Jfc Belli, LN Pascoalino, V. Carvalho, VS Issa, Lgb Cruz, E. Bocchi, J. Neder","doi":"10.1177/17418267100170s210","DOIUrl":"https://doi.org/10.1177/17418267100170s210","url":null,"abstract":"P160 Determinants and prognostic value of the VE/VCO2 slope as compared to neurohormonal activation in elderly patients with CAD and preserved LV function J H A J De Sutter, N Van De Veire, J Philippe, M De Buyzere Ghent University, Ghent, Belgium Topic: Biomarkers Background and study aims:The VE/CO2 slope is considered as a powerful predictor of cardiac events in patients with heart failure. In this study we evaluated the determinants and prognostic value of the VE/VCO2 slope in the ever increasing population of elderly patients with CAD and preserved LV function. We also compared the predictive value of the VE/CO2 slope with NTproBNP as marker of neurohormonal activation. Methods:We studied 89 patients 70 years or older (mean age 75 4 years, 85% men) with CAD and LVEF = 50% (mean LVEF 64 9 %). All patients underwent a maximal bicycle spiroergometry for the evaluation of VO2max and the VE/CO2 slope. Serum NT-proBNP, creatinine and high sensitivity CRP were determined. Echocardiography was performed to evaluate E/E as marker of LV filling pressures. Patients were followed for a median follow-up of 32months for the combined end-point of mortality, AMI, PCI, CABG or hospitalisation for heart failure. Results:Mean VO2max was 15,5 4,1 ml/kg/min andmean VE/CO2 slope was 32 6. Tertiles of VE/CO2 slope were associated with higher levels of NT-proBNP, hsCRP and E/E (all p-values < 0.05) but not with age, VO2max or creatinine levels. Patients with events during follow-up (n1⁄416) had higher values of VE/CO2 slope, NT-proBNP and creatinine but no differences were noted for age, VO2max, hsCRP and E/E . ROC analysis showed AUC values of 0,74 (95%CI 0,59-0,89, p<0.01) for NT-proBNP and 0,67 (95% CI 0,53-0,81, p<0.05) for VE/CO2 slope. In multivariate Cox regression analysis, VE/CO2 slope appeared as an independent predictor (p<0.05) for cardiac events. However, after introduction of NT-proBNP in the model, VE/CO2 did not remain as predictor, in contrast to NT-proBNP (p<0.01). Conclusions: In elderly patients with CAD and preserved LV function, increased levels of VE/ VCO2 slope are related to higher LV filling pressures as well as higher levels of parameters of neurohormonal and inflammatory activation. Although the VE/CO2 slope is a predictor of cardiac events, its predictive power is weaker as compared to NT-proBNP.","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":"17 1","pages":"S31 - S32"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/17418267100170s210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65490829","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}
Pub Date : 2010-05-01DOI: 10.1177/17418267100170s211
J. Cerveira, F. Paccaud, V. Mooser, G. Waeber, P. Vollenweider, Cornuz, P. Jankowski, S. Surowiec, M. Loster, A. Pajak, K. Kawecka-Jaszcz, P. Papasavvas, C. Karkadaris, D. Panagiotakos
P169 Escitalopram prevents depression in patients with acute coronary syndrome (DECARD): a randomized controlled trial BH Hansen, JA Hanash, A Rasmussen, JF Hansen, NLT Andersen, M Birket-Smith Bispebjerg Hospital of the Copenhagen University Hospital, Copenhagen, Denmark Topic: Controlled clinical trials Background and aims: Prevalence of depression in patients recovering from acute coronary syndrome (ACS) i.e., myocardial infarction and unstable angina is higher than in general population and depression is associated with poor cardiac outcomes and higher mortality. Despite these findings no trials of prevention of depression in post-ACS patients has been undertaken. The aim of the DEpression in Coronary ARtery Disease (DECARD) study was to evaluate the efficacy of one year preventive treatment with selective serotonin reuptake inhibitor escitalopram. Methods: In a double blind randomized study 240 non-depressed patients were enrolled within 8 weeks after ACS to treatment with escitalopram or matching placebo (5-20 mg). Primary outcome measure was development of clinical depression and score >13 on Hamilton Depression Scale (HDS). Results: During the one year study period, 12 patients developed depression, two in the escitalopram and ten in the placebo group (p1⁄4.017). Twenty-four patients had significant depressive symptoms (HDS>13), 7 in the escitalopram and 17 in the placebo group (p1⁄4.030). Conclusion: Escitalopram prevented depression and depressive symptoms during the first year after ACS.
艾司西普兰预防急性冠状动脉综合征(DECARD)患者抑郁:一项随机对照试验BH Hansen, JA Hanash, a Rasmussen, JF Hansen, NLT Andersen, M Birket-Smith Bispebjerg医院，哥本哈根，丹麦急性冠状动脉综合征(ACS)(即心肌梗死和不稳定型心绞痛)恢复期患者的抑郁患病率高于一般人群，抑郁与心脏预后不良和死亡率升高有关。尽管有这些发现，但尚未开展预防acs后患者抑郁的试验。冠状动脉疾病抑郁症(DECARD)研究的目的是评估选择性5 -羟色胺再摄取抑制剂艾司西酞普兰预防性治疗一年的疗效。方法:在一项双盲随机研究中，240名非抑郁症患者在ACS后8周内接受艾司西酞普兰或匹配安慰剂(5- 20mg)治疗。主要结局指标为临床抑郁的发展，汉密尔顿抑郁量表(HDS)评分为bb0 13分。结果:在一年的研究期间，12例患者出现抑郁症，艾司西酞普兰组2例，安慰剂组10例(p1 / 4.017)。24例患者有明显的抑郁症状(HDS为bb0.13)，艾司西酞普兰组为7例，安慰剂组为17例(p1 / 4.030)。结论:艾司西酞普兰可预防急性冠脉综合征后第一年的抑郁和抑郁症状。
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