Progress in cardiovascular diseases最新文献

Food choices and dietary behaviors are inherently complex and influenced by numerous interconnected factors including individual preferences such as taste, meal timing, and social interactions, alongside external elements like affordability, cultural norms, marketing, and policy environments. The physical contexts of food consumption - homes, schools, workplaces, and neighborhoods- further shape these behaviors, as do societal expectations and generational food literacy. Underpinning these dynamics are food systems, which are influenced by health, ethical, and sustainability considerations throughout the food production and consumption continuum. Cultural influences, encompassing traditions, rituals, and shared beliefs, play a pivotal role in shaping dietary practices. Distinctions between "cultural food" and "food culture" illustrate the deep integration of cuisine within identity and daily life. Historical events, globalization, and modernization have reshaped food traditions, leading to the adoption of new eating patterns and the erosion of others. Religion, socioeconomic status, and social networks also critically impact dietary behaviors, while contemporary challenges such as the nutrition transition and fast-food culture contribute to rising chronic disease burdens. Addressing these issues requires culturally tailored interventions and a focus on food environments, integrating modern tools like social media to promote healthier, community-oriented behaviors while recognizing the social and emotional roles of food.

A culture of health or healthy living can be envisioned as a society where well-being, including essential aspects like sleep, stress management, social connections, and leisure - is not merely an aspiration but a tangible reality for diverse communities, free from systemic inequities. However, the concept of a healthy lifestyle, and by extension a culture of healthy living, varies widely across the globe, shaped by cultural norms, government policies, and social structures. Defining a universally acceptable "culture of healthy living" for every population or subgroup is inherently complex, making it more practical to focus on addressing the barriers and leveraging the enablers associated with leading a healthy life. At its core, discussing the foundational elements of a healthy life - such as diet and nutrition, physical activity, mental health, and access to healthcare - is crucial. To ensure the sustainability of healthy living practices, a multifaceted approach is needed, emphasizing these pillars alongside equity. Existing global initiatives offer promising frameworks to tackle these challenges, highlighting the importance of collaboration, innovation, and systemic change. By fostering mutual support and collective action, we can advance toward a global culture of healthy living that benefits all individuals and communities, leaving no one behind.

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.

Background: Resting Heart Rate (RHR) is commonly viewed as a reflection of underlying co-morbidities and not an independent risk factor. Here we compared whether high RHR (80-99 beats/min) and hypertension (blood pressure, BP ≥140/90 mmHg) independently predict all-cause mortality in 692,217 adults from Asia and Europe.

Methods: Taiwan MJ cohort constituted of 636,064 adults (1994-2017) and the HUNT cohort of 56,153 Norwegian adults (1995-1997). Both cohorts were followed for about 25 years. We report adjusted hazard ratios (HRs) for all-cause mortality, and life expectancy were calculated.

Results: The prevalence of high RHR changed little between those aged 20-29 years (21.2 %) and ≥ 70 years (25.2 %, ns.), whereas hypertension prevalence increased from 4.5 % to 57.3 %, respectively. We observed similar all-cause mortality among those with a high RHR and a normal BP and those with hypertension and normal RHR of 60-69 beats/min. We observed higher all-cause mortality among those with normal BP (≤120/80 mmHg) but high RHR than among those with hypertension and normal RHR. All-cause mortality risk associated with hypertension was not significant for those <40 years of age, whereas risk associated with high RHR remained significant across all age groups. Reductions in life expectancy was larger among individuals with normal BP, but high RHR (10.29 years, 95 % CI 8.09-12.49) compared with those with hypertension but normal RHR (5.53 years, 95 % CI 3.57-7.59).

Conclusions: Our data clearly demonstrate that elevated RHR should be considered as an independent risk factor for all-cause mortality. The observation that elevated RHR in young adulthood to middle age (20-50 years of age) served as better predictor of all-cause mortality than hypertension calls for a paradigm shift particularly among these age groups, and we suggest it is time that RHR should be regarded as a vital clinical sign measured and evaluated at all clinical visits.

Background: The six-minute walk test (6MWT) is a prognostic sub-maximal exercise test used clinically as a measure of functional capacity. With the emergence of advanced sensors, 6MWTs are being performed remotely via smartphones and other devices. The My Heart Counts Cardiovascular Health Study is a smartphone application that serves as a digital platform for studies of human cardiovascular health, and has been used to perform 30,475 6MWTs on 8922 unique participants.

Objective: As our 30,475 6MWTs represent the largest such collection of data available, we sought to identify associations with measured demographic and clinical variables with 6MWT distance at enrollment and separately determine if use of the My Heart Counts smartphone application led to changes in 6MWT distance.

Methods and results: We present the public data release of our 30,475 6MWTs and the launch of a webpage-based data viewer of summary-level statistics, to compare the functional capacity of an individual by their age, gender, height, weight, and disease status (https://mhc-6mwts.streamlit.app). Using multivariable regression, we report associations of demographic and clinical variables with baseline 6MWT distance (N = 3606), validating prior associations with age, male gender, height, and baseline physical activity level with 6MWT distance. We also report associations of 6MWT baseline distance with employment status (+12.4 m ±4.9 m, P = 0.011) and feeling depressed (-3.65 m, ±0.79 m, P < 0.001). We separately found that cardiovascular disease status was significantly associated with decreased 6MWT distance for atrial fibrillation (-24.9 m ±7.8 m, P = 0.0013), peripheral artery disease (-41.7 m ±12.5 m, P < 0.001), and pulmonary arterial hypertension (-76.3 m ±24.8 m, P = 0.0022). Heart failure was associated with decreased 6MWT distance but was not statistically significant (-25.5 m ±14.5 m, P = 0.078). In a subset of participants who conducted repeat 6MWTs separated by at least 1 week but no greater than 3 months (N = 1129), we found that use of the My Heart Counts app was associated with a statistically significant increase in 6MWT distance (+17.5 m ±7.85 m, P < 0.001).

Conclusions: We validate previously identified associations from clinic-performed 6MWTs, demonstrating the utility of a mobile method in collecting 6MWT data for clinicians and researchers. We also demonstrate that use of the My Heart Counts app is associated with small, but significant increases in 6MWT distance. Given the importance of 6MWTs in assessment of functional capacity, our publicly-available data will serve an important purpose as a health and disease-specific reference for investigators worldwide.

Ischemic heart disease is the most common cardiovascular cause of death in women worldwide. Obstructive coronary atherosclerosis is the primary cause of myocardial infarction (MI), however, non-atherosclerotic mechanisms of MI, such as spontaneous coronary artery dissection, vasospasm, microvascular dysfunction, embolization, inflammation, coronary anomalies, infectious and infiltrative causes are increasingly being recognized. Emerging data suggest that women are two to five times more likely to have an MI in the absence of coronary atherosclerosis compared to men, but they continue to remain underdiagnosed and undertreated, partly due to underdiagnosis and limited understanding of these mechanisms. Recent advancements in invasive and noninvasive imaging techniques and physiological testing allow for distinguishing these mechanisms from each other, providing a definitive diagnosis and tailored treatment. This review summarizes the existing literature on the non-atherosclerotic coronary causes of MI with a focus on evidence pertaining to women, offering a basis for future studies.

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.

The Roundtable on Obesity Solutions (ROOS), established in 2014, is a unique organization of multisectoral voices addressing the public health challenge of obesity. The ROOS brings together practitioners, researchers, funders, companies, health systems, government agencies, and the lived experience to dialogue and guide the national conversation about the multilevel challenges and opportunities related to obesity. This paper presents insights and key learnings from a symposium developed to celebrating the 10th Anniversary of the ROOS. The first six years (2014-2019) of the ROOS marked a period in which dialogue was initiated, multi-sectoral perspectives were captured, and important viewpoints were deliberated and published. In 2020, the ROOS engaged in a strategic planning process enabled by systems science that ultimately resulted in the creation of a roadmap focused on drivers and solutions of obesity. This roadmap generated an agenda focused on upstream social and structural drivers of obesity with an emphasis on the integration of equity, gaps, strategies, and the lived experience. Three main priorities identified in this roadmap included structural racism, social norms, and health communications. Based on this work, the ROOS has had significant impact in the areas of equity, weight stigma, and the lived experience. Much work remains. To date, obesity solutions available for prevention and treatment have been vastly underutilized. Future directions should: 1) include increasing access to effective prevention and treatment options; 2) a focus on how best to implement new technologies in obesity prevention and care; 3) addressing issues of equity, literacy, and stigma that remain unresolved; and 4) leveraging the influence of regional cultures, policies, and social norms. We hope that insights gained over the previous 10 years will inspire another decade of impact for the ROOS.