bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of cardiovascular health status on the association between changes in physical activity and major cardiovascular events and mortality among 88,320 adults: outcomes of the Lifelines Cohort Study
Authors: Bakker EA , Lee DC , Hopman MTE , Thijssen DHJ , Eijsvogels TMH 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Lifelines Biobank initiative received funding from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen [UMCG], University Groningen and the Northern Provinces of the Netherlands. The work of T.M.H.E is supported by the Netherlands Heart Foundation [Senior E-Dekker grant #2017T051].
Background. Regular physical activity (PA) improves health. Many observational studies investigated the association between PA and health at a single time-point, but PA might change over time.
Purpose. To examine the association between change in PA and major adverse cardiovascular events (MACE) and all-cause mortality, and to investigate the impact of cardiovascular health status at baseline on these outcomes.
Methods. This study used data from the Lifelines Cohort Study (N = 88,320). Self-reported PA volumes were presented as Metabolic Equivalent of Task (MET) min/week. Change in PA was calculated by subtracting MET-min/week at the first assessment from the second assessment (median interval: 4 yrs), and 5 groups were created; large reduction (&lt; -1500), moderate reduction (-1500 to -250), no change (-250 to 250), moderate improvement (-250 to 250) and large improvement (&gt;1500). The outcome was a combination of MACE and all-cause mortality.
Results. During a median follow-up of 7 years, 667 events occurred among healthy individuals (43 ± 12 yrs, 1% of 69,818) and 599 in individuals with CVRF (55 ± 11 yrs, 3% of 18,502). Adjusted for confounders and baseline PA, healthy individuals with a large reduction in PA had a greater risk of incident MACE and mortality (Table). In CVRF, moderate to large improvements in PA were associated with reductions in adverse outcomes. Risk estimates became stronger in individuals with lower baseline PA (&lt;2000 MET-min/week), Table).
Conclusions. Maintaining PA in healthy individuals and increasing PA in individuals with CVRF over time is important to prevent MACE and mortality. The impact of changes in PA was stronger for individuals with lower baseline PA.
Table. Change of PA, MACE and mortality. Changes in PA Healthy CVRF Large reduction 1.40 [1.02;1.93] 1.27 [0.95;1.70] Moderate reduction 1.22 [0.89;1.68] 0.97 [0.72;1.30] No changes Ref Ref Moderate improvement 1.04 [0.74;1.44] 0.65 [0.47;0.91] Large improvement 0.96 [0.71;1.31] 0.69 [0.51; 0.94] Individuals with lower baseline PA Large reduction 2.24 [0.96;5.21] 2.85 [1.44;5.63] Moderate reduction 1.77 [1.10;2.84] 1.33 [0.89;1.98] No changes Ref Ref Moderate improvement 1.16 [0.73;1.83] 0.49 [0.31;0.76] Large improvement 0.77 [0.48;1.23] 0.58 [0.39;0.86]
Impact of regular physical activity awareness sessions by primary care physicians in rural India
Authors: Inamdar A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Regular physical activity is associated with improved physical and mental health. Studies have shown that regular physical activity reduces the risk of cardiovascular diseases, diabetes mellitus, osteoporosis, depression and obesity. Patients frequently identify their family physicians as an important source of constant encouragement for physical activity.

Purpose
We wanted to assess the impact of regular awareness sessions about physical activity by Primary care physicians in adults.

Methods
73 participants between the age group 30 to 60 years were recruited in this single center study in rural India.70 participants completed this 6 month intervention study whereas 3 participants dropped out of study. Once in a month audio visual awareness session of one hour were conducted from August 2017 to January 2018 by primary care physicians to educate the participants about ill effects of sedentary lifestyle and benefits of regular physical activity. Pre and post intervention data were collected by using validated Godin leisure time exercise questionnaire from all 70 participants. Paired t test and Wilcoxon test were used to compare pre- and post-intervention data. Percentage increase in physical activity score was also calculated.

Results
In this study baseline Godin score pre intervention were 38.82 ± 12.22 (Mean ± SD) and post intervention were 65.98 ± 11.25 (Mean ± SD). Participants significantly improved Godin score post intervention which were statistically significant (p: &lt; 0.001) . Compared to baseline pre intervention score, there was 170% increase in physical activity score post intervention.

Conclusions
Results of this intervention suggest that regular awareness sessions using modern technology is cost effective in changing physical activity behavior in people. Active involvement of primary care physician in this intervention will further help in establishing and continuing physical activity behavior. Physicians can play a major role in promotion of physical activity. As primary care physicians have direct regular contact with their patients and their families, their role in promotion of physical activity will have more impact and long-lasting effect on patient’s behavior. We assume that similar studies are needed to promote physical activity in the people.
Sleep insufficiency and incidence of cardiovascular disease among adults in Greece
Authors: Fountoulakis PN , Terzoudi A , Tsiptsios D , Triantafyllis AS , Matziridis A , Leontidou E , Manolis A , Tsamakis K , Ouranidis A , Steiropoulos P , Vorvolakos T , Tripsianis G 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Sleep disorders are an increasing and modifiable risk factor for cardiovascular disease (CVD).

Purpose
The aim of our study was to investigate potential associations between sleep insufficiency and incident CVD.

Methods
In this cross-sectional study, 957 participants, (mean age 49.62 ± 14.79) from the region of Thrace, Greece were enrolled and classified into three groups [short (&lt;6 h), normal (6-8 h) and long (&gt;8 h) sleep duration]. CVD was assessed by a positive response to the following questions: "Have you been told by a doctor that you have had a heart attack or angina (chest pain or exertion that is relieved by medication)?" or "Have you been told by a doctor that you have had a stroke?". Participants’ sleep quality was estimated with the Epworth Sleepiness Scale, Athens Insomnia Scale, Pittsburgh Sleep Quality Index, and Berlin Questionnaire.

Results
The overall prevalence of CVD was 9.5%. The population with CVD exhibited reduced sleep duration and efficiency reduced by 33 min and 10%, respectively. After adjusting for all possible cofounders, short sleep duration was 3.07-times more frequent in patients with CVD and sleep duration of less than 5:33 hours could be a potential risk factor for CVD, especially among females. Additionally, CVD was significantly associated with excessive increased daytime sleepiness, insomnia, poor sleep quality and increased risk of obstructive sleep apnea.
Conclusion(s): Our study depicts a strong correlation of sleep insufficiency with CVD and promotes early pharmacological or cognitive behavioral interventions in order to protect cardiovascular health.
Abstract Figure. Results
Rationale and design of remotely-supervised cardiac rehabilitation study in patients with obstructive sleep apnea
Authors: Hnatiak J , Ludka O , Batalik L , Winnige P , Dosbaba F 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Ministry of Health Czech Republic; identification of organization 65269705

Background
Although continuous positive airway pressure (CPAP) is currently still the gold standard for therapy of moderate to severe obstructive sleep apnea (OSA), another alternative or adjunct effective therapeutic options exist. Lifestyle intervention focused on nutrition and weight reduction, regular exercise, sleep hygiene, smoking and alcohol restriction represents a recommended therapeutic strategy for OSA. Though this intervention represents an effective tool for improving objective and subjective parameters of OSA, it’s effectivity depends on components of the intervention, OSA severity and gender. Comprehensive remotely-supervised cardiac rehabilitation (CR) represents possible training intervention in home conditions using elements of telemedicine.

Purpose
This prospective study aims to investigate the feasibility and effect of a remotely-supervised CR in patients with newly diagnosed OSA with Apnea-Hypopnea Index greater than 15 episodes per hour.

Methods
This monocentric study is designed as a prospective, parallel, randomised, controlled trial of remotely-supervised 12-week CR in male patients between 40-60 years old with newly diagnosed OSA indicated to CPAP therapy. The sample size is calculated by 0,05 level of significance and 80% statistical power on 25 participants in each group. The Intervention group will undergo comprehensive remotely-supervised CR in home conditions with teleconsultation (contains telecoaching, telemonitoring) via regular phone calls and e-mails at least 1-2 times a week. The intervention will include nutrition, health-related lifestyle and behavioral changes recommendations, and at least 5 times a week 30 minutes of moderate-intensity aerobic training, 10 minutes of inspiratory and expiratory muscle training with breathing device and 10 minutes of oropharyngeal exercise along with individually titrated CPAP therapy. The control group will undergo individually titrated CPAP therapy only. The participants in both groups will go through the following assessments before and after this study: polysomnography, spirometry, anthropometry and body composition examination, laboratory values examination, quality of life questionnaires, Epworth sleepiness scale, 6-min walking test. Conclusions: Comprehensive remotely-supervised CR, as mentioned in this study, may represent an adjunct therapy with a promising future in patients with OSA. The study is occupied with a current issue and can also bring new possibilities and experiences in remote rehabilitation.
Cardio-metabolic risk factors among healthcare staff: a cross-sectional study at the hospitals in six cities of Ukraine dedicated to World Heart Day 2020
Authors: Sulska I , Mishchenko L , Sorokolietova A , Hordina M , Zhulinska S 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. There is a little information on the prevalence of cardio-metabolic risk factors in the Ukrainian medical staff. The aim of investigation was to determine the abundance of certain risk factors for cardiovascular (CV) diseases among the medical personnel in the six cities of Ukraine, a study dedicated to World Heart Day 2020.
Purpose. To establish the presence of cardio-metabolic risk factors among medical workers in Ukraine.
Materials and methods. A hospital-based cross-sectional study including 471 participants (415 female and 56 male) between the age of 19 and 79 years surveyed. The cardio-metabolic risk markers assessed were non-modifiable risk factors (family history) and modifiable risk factors (obesity, hypertension, dyslipidemia, diabetes, prediabetes, smoking status).
The prevalence of hypertension (HTN) estimated by ESC 2018 recommendations, diabetes and prediabetes by ADA 2019, ESC 2019 and body mass index WHO criteria for obesity classifications. Using standard methods were assessed: fasting glucose concentration, glycosylated hemoglobin (HbA1c) and blood lipids (total cholesterol, LDL-C, triglycerides, HDL-C).

Results
The median age of participants was 53,3 ± 11,77 years. Positive smoking status reported by 66 persons (14,0%). Analysis of family history showed that 51,4% of the participants had of HTN, 14,9% of myocardial infarction and 25,1% of stroke. The prevalence of modifiable risk factors: HTN registered in 51,4% cases. Around 34,8% of participants were overweight, and 34,6% were obese, 70,7% had waist circumference more than 94 cm (men) and &gt; 80 cm (woman). Prediabetes glycemic levels and diabetes incidence were 42,8% and 12,6%, accordingly. Atherogenic dyslipidemia estimated by increased level of LDL-C more than 4,9 mmol/l, which determinate high risk of CV disorders, estimated in 13,6% participants. Also high triglycerides levels were defined as those of at least 2,3 mmol/l were in 14,9%. Low level of aerobic activity (less than 150 min in week) had 33,4% participants. 30,7% of participants older than 40 years presented high CV risk and 23,9% were in very high risk.
Conclusion. Cardio-metabolic risk factors prevail among medical workers in Ukraine. The results point to the relevance of public health recommendations to contribute lifestyle changes and early identification of risk factors for prevention of CV outcomes.
Association between retinopathy and development of long-term cardiovascular events. Results of the follow-up of RETICARD cohort
Authors: Aguila Gordo D , Marina Breysse M , Piqueras Flores J , Negreira Caamano M , Mateo Gomez C , Martinez Del Rio J , Moron Alguacil A , Perez Diaz P , Perez Soto R , Cubides Novoa AF , Munoz Garcia M , Frias Garcia R , Salas Bravo D 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Although the association between retinopathy and cardiovascular disease is known, the usefulness of retinopathy as a risk predictor has not been well studied yet.

Methods
Prospective study of a cohort of 107 patients with a medical indication for coronary angiography, who underwent a fundus study to assess the presence of retinopathy. The appearance of major cardiovascular events defined by cardiovascular mortality, acute coronary syndrome, cerebrovascular accident, new revascularization, hospital readmission for cardiovascular causes and development of atrial fibrillation (AF) was recorded in a follow-up with a mean of 110, 96 + / -19.74 months.

Results
The mean age was 75.19 ± 11.53 years. 39.3% were women, 78.5% suffered from hypertension, 32.7% diabetes, and 57% dyslipidaemia. 84.1% had some type of retinopathy at the beginning of follow-up: 0.9% diabetic, 3.7% hypertensive, 1.9% atherosclerotic, and 70.1% hypertensive-atherosclerotic.
During the follow-up, all causes mortality was 16.8% and cardiovascular mortality 2.8%. 5.6% of the sample presented an acute ischemic event. 6.5% required new myocardial revascularization. The proportion of patients who developed AF was 11.2%. The readmission rate for all causes 60.7% (cardiovascular cause 28%).
Grade ≥ 2 hypertensive retinopathy was associated with a greater need for myocardial revascularization (p = 0.016), being performed earlier than the rest of the patients (108.6 ± 3.9 vs 118.8 ± 0.2 months; p = 0, 01). Atherosclerotic retinopathy was related to a greater development of AF (p = 0.04), appearing in 21.2% of these patients compared to 6.75% in the rest. A greater trend to readmission for cardiovascular causes (p = 0.66) was observed in patients with diabetic retinopathy; 16.13% compared to 5.26% in patients who did not suffer from it.

Conclusions
The presence of retinopathy, in its different types, is associated with the early development of major cardiovascular events, therefore, the inclusion of the fundus in the initial study of cardiovascular risk may be beneficial to improve risk stratification.
Very similar cardiometabolic profile in the moderate and high cardiovascular risk classes: a population-based study
Authors: Chlabicz M , Jamolkowski J , Laguna W , Sowa P , Paniczko M , Lapinska M , Szpakowicz M , Drobek N , Raczkowski A , Kaminski K,A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Bialystok, Poland

Background
Cardiovascular disease (CVD) is a major, worldwide problem and remain the dominant cause of premature mortality in the word. Simultaneously the metabolic syndrome is a growing problem. The aim of this study was to investigate the cardiometabolic profile among cardiovascular risk classes, and to estimate CV risk using various calculators.

Methods
The longitudinal, population-based study, was conducted in 2017-2020. A total of 931 individuals aged 20-79 were included. Anthropometric and biochemical profiles were measured according to a standardized protocols. The study population was divided into CV risk classes according to the latest recommendation. Comparisons variables between subgroups were conducted using Dwass-Steele-Critchlow-Fligner test. To estimate CV risk were used: the Systematic Coronary Risk Estimation system, Framingham Risk Score and LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people (LIFE-CVD).

Results
The mean age was 49.1± 15.5 years, 43.2% were male. Percentages of low-risk, moderate-risk, high-risk and very-high CV risk were 46.1%, 22.8%, 13.5%, 17.6%, respectively. Most of the analyzed anthropometric, body composition and laboratory parameters did not differ between the moderate and high CV risk participants, whereas the low risk group differed significantly. In the moderate and high-risk groups, abdominal distribution of adipose tissue dominated with significantly elevated parameters of insulin resistance. Interestingly, estimating lifetime risk of myocardial infarction, stroke or CV death using LIFE-CVD calculator yielded similar results in moderate and high CV risk classes.

Conclusion
The participants belonging to moderate and high CV risk classes have a very similar unfavorable cardiometabolic profile which may result in the similar lifetime CV risk. This may imply the need for more aggressive pharmacological and non-pharmacological management of CV risk factors in the moderate CV risk population. It would be advisable to consider combining the moderate and high risk classes into one high CV risk class, or it may be worth adding one of the parameters of abdominal fat distribution to the CV risk calculators as an expression of increased insulin resistance.
Abstract Figure 1.
The association between S1P and vascular disease markers in the general population
Authors: Rotheudt L , Moritz E , Markus M , Voelzke H , Friedrich N , Rauch B , Schwedhelm E , Buelow R , Schminke U , Felix S , Doerr M , Bahls M 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction
Sphingosine-1-phosphate (S1P) is a lipid mediator of the immune system and vascular bed. However, cross-sectional analyses of S1P and parameters of vascular health in the population are sparse.
Purpose
We explored the relation between S1P concentrations and several parameters of vascular health, i.e. ankle-brachial index (ABI), carotid intima-media thickness (cIMT), presence of carotid atherosclerotic plaques/stenosis, brachial artery flow-mediated dilation (FMD) as well as aortic wall thickness (AWT).

Methods
S1P was measured by liquid chromatography-tandem mass spectrometry in the population-based Study of Health in Pomerania (SHIP-TREND-0). ABI was calculated as the ratio of systolic blood pressure in arms and ankles. For cIMT, the distance between the lumen-intima and media-adventitia interfaces in longitudinal scans were measured. Carotid plaques were defined as a focal protrusion of the carotid vessel wall. Carotid stenosis was assessed with Doppler ultrasonography. FMD was evaluated by measuring the increase in brachial artery diameter after transient forearm ischemia. AWT was assessed by Magnetic Resonance Imaging. Subjects with cancer, severe renal insufficiency, previous myocardial infarction and extreme values for S1P (&lt; 1st and &gt; 99th percentile) were excluded. Sex stratified linear regression models adjusted for age, smoking, waist-to-hip ratio and platelets were used to assess the relation between S1P and vascular disease parameters.

Results
A total of n = 3,643 participants (48% male, median age 51, 25th and 75th percentile 39 and 63 years) could be included in the analyses. The median S1P concentration was 0.788 µM (25th and 75th percentile 0.679 and 0.906, respectively). In men a 1 standard deviation higher S1P was associated with a significantly greater cIMT (β: 0.0057 95% confidence interval [CI]: 0.00027 to 0.0112 mm; p = 0.0396) and a lower ABI (β: -0.0090 (95% confidence interval [CI]: -0.0153 to -0.0029; p = 0.0038. In women S1P was significantly associated with cIMT (β: 0.0044 95% confidence interval [CI]: 0.0001 to 0.0086 mm; p = 0.0445) while no significant association was found for the relation of S1P with ABI. For both men and women S1P was not associated with FMD, the presence of carotid plaques/stenosis and AWT.

Conclusions
We found that S1P concentrations were positively related to a thicker cIMT in both sexes and lower ABI values in men. There was no association of S1P with any of the other vascular markers of interest. Future studies need to validate our results in other populations.