Q90032466 Dotaz Zobrazit nápovědu
BACKGROUND: Although obesity is a risk factor for stroke and achieving normal weight is advocated to decrease stroke risk, the risk associated with obesity and weight loss after stroke has not been well established. The aim of this study was to assess the association of obesity at the time of stroke admission and weight loss after stroke with total mortality. METHODS: We analyzed 736 consecutive patients (mean age, 66 ± 11 years; 58% men) hospitalized for their first ischemic stroke. Body weight at hospital admission and at the outpatient visit during follow-up was used in the analysis. RESULTS: After multivariate adjustment, obesity at admission was associated with lower mortality risk as compared with normal weight (hazard ratio [HR], .50, P = .03). At the outpatient visit, with a median follow-up time of 16 months, 21% of patients had lost more than 3 kg of weight. Stroke severity, heart failure, transient ischemic attack, and depression after stroke were independently associated with significant weight loss. Weight loss of more than 3 kg was associated with increased mortality risk (HR, 5.87; P = .001) independently of other factors. Similar results were seen when weight loss was defined as losing more than 3% of baseline weight (HR, 4.97; P = .004). Weight gain of more than 5% of the baseline weight tended to be associated with better survival when compared with no weight change (log-rank test, P = .07). CONCLUSIONS: Normal weight at hospital admission and weight loss after ischemic stroke are independently associated with increased mortality. Overweight and obesity at baseline do not decrease the risk associated with weight loss.
- MeSH
- cévní mozková příhoda komplikace mortalita patofyziologie MeSH
- hmotnostní úbytek fyziologie MeSH
- index tělesné hmotnosti MeSH
- lidé středního věku MeSH
- lidé MeSH
- obezita komplikace patofyziologie MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- cholesterol dietní škodlivé účinky MeSH
- dietní sacharidy škodlivé účinky MeSH
- dietní tuky nenasycené aplikace a dávkování MeSH
- lidé MeSH
- obezita dietoterapie MeSH
- proteiny aplikace a dávkování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- randomizované kontrolované studie MeSH
- Geografické názvy
- Spojené státy americké MeSH
- MeSH
- kardiovaskulární nemoci * prevence a kontrola MeSH
- Publikační typ
- novinové články MeSH
- rozhovory MeSH
Cíl: Zjistit užívání tabáku a některé charakteristiky osob užívajících tabák (osob užívajících elektronické cigarety) související s kardiovaskulárními onemocněními u reprezentativního vzorku populace města Brno. Metody: Za použití metodologie studie Czech post-MONICA bylo v roce 2013 ve městě Brno (Česká republika) provedeno průřezové šetření kardiovaskulárních rizikových faktorů. Tato předběžná zpráva s údaji prvních 965 náhodně vybraných dobrovolníků (včetně 512 žen) ve věku 25–64 let se zaměřuje na užívání tabáku, jeho prevalenci v různých podskupinách i na postoje vůči zákonům a nařízením omezujícím kouření. Výsledky: Tato předběžná analýza hodnotí údaje 965 jedinců průměrného věku 47,3 ± 11,40 roku. Prevalence kouření byla 26,7 %; denně kouřilo 23,3 %, příležitostně (méně než jednou denně) 3,4 %; 19,9 % vzorku byli bývalí kuřáci. Celkem 34,0 % populace bylo exponováno tabáku. Užívání elektronických cigaret uvedlo 3,5 % respondentů, častěji šlo o muže (5,1 %) než o ženy (2,1 %; p = 0,020). Souběžné užívání elektronických cigaret a kouření uvedlo 2,07 % hodnocené populace. Závěr: Prevalence užívání tabáku brněnskou populací v produktivním věku je 26,70 %, což je stále ještě vysoké číslo.
Aim: To assess tobacco use and some characteristics of tobacco users (including electronic cigarette users) relevant to cardiovascular disease in a representative population sample of the city of Brno. Methods: A cross-sectional survey of cardiovascular risk factors was conducted using the methodology of the Czech post-MONICA Study, in the city of Brno, Czech Republic in 2013. This preliminary report of the first 965 randomly selected volunteers (including 512 women) aged 25–64, focuses on tobacco use, its prevalence in different subgroups as well as on the attitudes towards smoke-free policies. Results: This preliminary analysis involves 965 individuals with a mean age of 47.3 ± 11.40 years. The prevalence of smoking was 26.7%, with daily tobacco use 23.3%, less than once daily 3.4%; 19.9% of the sample are ex-smokers. A total of 34.0% of the survey population reported exposure to passive smoking. Electronic cigarette use was observed in 3.5% of respondents, more common in men (5.1%) than in women (2.1%; p = 0.020). Concomitant use of electronic cigarettes and smoking was observed in 2.07% of the population. Conclusion: The prevalence of tobacco use in the productive-age population of Brno City district is 26.70%, still a high figure.
- MeSH
- antropometrie MeSH
- dospělí MeSH
- kardiovaskulární nemoci MeSH
- kouření * epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- odvykání kouření statistika a číselné údaje MeSH
- postoj MeSH
- prevalence MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- socioekonomické faktory MeSH
- užívání tabáku * epidemiologie MeSH
- věkové rozložení MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- antropometrie MeSH
- index tělesné hmotnosti MeSH
- ischemická choroba srdeční * prevence a kontrola MeSH
- lidé MeSH
- metaanalýza jako téma MeSH
- plošný screening MeSH
- pracovní expozice MeSH
- preventivní lékařství * MeSH
- programy Healthy People * MeSH
- rizikové faktory MeSH
- surveillance populace MeSH
- ukončení užívání tabáku MeSH
- vystavení vlivu životního prostředí MeSH
- vzdělávání pacientů jako téma MeSH
- zdravotnické plány - realizace MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
Background There is a scarcity of validated rapid dietary screening tools for patient use in the clinical setting to improve health and reduce cardiovascular risk. The Healthy Eating Index (HEI) 2015 measures compliance with the 2015 to 2020 Dietary Guidelines for Americans but requires completion of an extensive diet assessment to compute, which is time consuming and impractical. The authors hypothesize that a 19-item dietary survey assessing consumption of common food groups known to affect health will be correlated with the HEI-2015 assessed by a validated food frequency questionnaire and can be further reduced without affecting validity. Methods and Results A 19-item Eating Assessment Tool (EAT) of common food groups was created through literature review and expert consensus. A cross-sectional survey was then conducted in adult participants from a preventive cardiology clinic or cardiac rehabilitation and in healthy volunteers (n=661, mean age, 36 years; 76% women). Participants completed an online 156-item food frequency questionnaire, which was used to calculate the HEI score using standard methods. The association between each EAT question and HEI group was analyzed by Kruskal-Wallis test. Linear regression models were subsequently used to identify univariable and multivariable predictors for HEI score for further reduction in the number of items. The final 9-item model of Mini-EAT was validated by 5-fold cross validation. The 19-item EAT had a strong correlation with the HEI score (r=0.73) and was subsequently reduced to the 9 items independently predictive of the HEI score: fruits, vegetables, whole grains, refined grains, fish or seafood, legumes/nuts/seeds, low-fat dairy, high-fat dairy, and sweets consumption, without affecting the predictive ability of the tool (r=0.71). Conclusions Mini-EAT is a 9-item validated brief dietary screener that correlates well with a comprehensive food frequency questionnaire. Future studies to test the Mini-EAT's validity in diverse populations and for development of clinical decision support systems to capture changes over time are needed.
- MeSH
- dieta * MeSH
- ovoce MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- zelenina * MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Background There is wide variability in cardiac rehabilitation (CR) dose (ie, number of sessions) delivered, and no evidence-based recommendations regarding what dose to prescribe. We aimed to test what CR dose impacts major adverse cardiovascular events (MACEs). Methods and Results This is an historical cohort study of all patients who had coronary artery disease and who initiated supervised CR between 2002 and 2012 from a single major CR center. CR dose was defined as number of visits including exercise and patient education. Follow-up was performed using record linkage from the Rochester Epidemiology Project. MACEs included acute myocardial infarction, unstable angina, ventricular arrhythmias, stroke, revascularization, or all-cause mortality. Dose was analyzed in several ways, including tertiles, categories, and as a continuous variable. Cox models were adjusted for factors associated with dose and MACE. The cohort consisted of 2345 patients, who attended a mean of 12.5±11.1 of 36 prescribed sessions. After a mean follow-up of 6 years, 695 (29.65%) patients had a MACE, including 231 who died. CR dose was inversely associated with MACE (hazard ratio, 0.66 [95% CI]; 0.55-0.91) in those completing ≥20 sessions, when compared with those not exposed to formal exercise sessions (≤1 session; log-rank P=0.007). We did not find evidence of nonlinearity (P≥0.050), suggesting no minimal threshold nor ceiling. Each additional session was associated with a lower rate of MACE (fully adjusted hazard ratio, 0.98 [95% CI, 0.97-0.99]). Greater session frequency was also associated with lower MACE risk (fully adjusted hazard ratio, 0.74 [95% CI, 0.58-0.94]). Conclusions CR reduces MACEs, but the benefit appears to be linear, with greater risk reduction with higher doses, and no upper threshold.
