Healthy Lifestyle Changes Research Articles

Using Peer Support to Prevent Diabetes: Results of a Pragmatic RCT

High-contact structured diabetes prevention programs are effective in lowering weight and HbA1cs, yet their intensity level can create barriers to participation. Peer support programs improve clinical outcomes among adults with Type 2 diabetes, but their effectiveness in diabetes prevention is unknown. This study examined whether a low-intensity peer support program improved outcomes more than enhanced usual care in a diverse population with prediabetes. The intervention was tested in a pragmatic 2-arm RCT. Participants were adults with prediabetes at three healthcare centers. Participants randomized to the enhanced usual care arm received educational materials. Participants in the Using Peer Support to Aid in Prevention and Treatment in Prediabetes arm were matched with a peer supporter: another patient who had made healthy lifestyle changes and was trained in autonomy-supportive action planning. Peer supporters were instructed to provide weekly telephone support to their peers on specific action steps toward behavioral goals for 6 months, then monthly support for 6 months. Changes in primary outcomes of weight and HbA1c and secondary outcomes of enrollment in formal diabetes prevention programs, self-reported diet, physical activity, health-specific social support, self-efficacy, motivation, and activation at 6 and 12 months were examined. Data collection occurred from October 2018 to March 2022, with analyses completed in September 2022. Among 355 randomized patients, in intention-to-treat analyses, there were no between-group differences in HbA1c or weight changes at 6 and 12 months. Using Peer Support to Aid in Prevention and Treatment in Prediabetes participants were more likely to enroll in structured programs at 6 (AOR=2.45, p=0.009) and 12 (AOR=2.21, p=0.016) months and to report eating whole grains at 6 (4.49, p=0.026) and 12 (4.22, p=0.034) months. They reported greater improvements in perceived social support for diabetes prevention behaviors at 6 (6.39, p<0.001) and 12 (5.48, p<0.001) months, with no differences in other measures. A stand-alone, low-intensity peer support program improved social support and participation in formal diabetes prevention programs but not weight or HbA1c. It will be important to examine whether peer support could effectively complement higher-intensity, structured diabetes prevention programs. This trial is registered at ClinicalTrials.gov, NCT03689530. Full protocol available at https://clinicaltrials.gov/ct2/show/NCT03689530.

Performance Comparison for Hearth Rate Signal Detection for Different Location in Fingertip and Wrist Using Sensor MAX30102

Abstract. Measuring vital body signals is essential to measure basic body functions, prevent misdiagnosis, detect underlying health problems and motivate healthy lifestyle changes. Vital body signals are measured at the fingertips because the skin is thin, and the blood vessels are transparent. Visible light is passed at the fingertips, and the pulses generated are still acceptable on the outer nail. However, the body's vital signal measuring device continuously attached to the fingertip causes discomfort to the user. Therefore, in this study, it is proposed to measure the body's vital signals in other body parts. The wrist was chosen to be attached to the body's vital signal measuring device because the measuring device attached to the wrist allows it to continue to be used. This study aims to measure the body's vital signals, especially heart rate, on the wrist so that the correlation level of the measurement data is known. The main contribution of this study is built an electronic system to measure vital body signals, especially heart rate at the wrist with the help of the MAX30102 sensor that uses visible light with 650 - 670 nm. The MAX30102 sensor, which uses visible light with 650 - 670 nm, was selected for measurement. The ratio of the light reflected through the fingertips compared to the wrist. The result of measuring the heart rate signal on the wrist is in the form of a relatively flat wave so that the data sharpening process is carried out using the detrend method. The results showed that the measurement of heart rate signals at the wrist and fingertips of 15 respondents had accuration 85%. The accuration value shows that the data from the heart rate signal at the wrist is closely correlated with the data from the measurement of the heart rate signal at the fingertips. Therefore, measurements of heart rate signals, usually performed on the fingertips, can also be performed on the wrist. From the test results with a strong accuration, measurements are always taken when the hand can measure the place to measure vital signals, which is usually done at the fingertips.

Exploratory analysis of the effect of a controlled lifestyle intervention on inflammatory markers – the Healthy Lifestyle Community Programme (cohort 2)

BackgroundChronic low-grade inflammation is associated with an increased risk of chronic disease and mortality. The objective of the study was to test the effect of a healthy lifestyle intervention on biomarkers of inflammation (among other risk markers).MethodsWe conducted a non-randomized controlled trial with mostly middle-aged and elderly participants from the general population in rural northwest Germany (intervention: n = 114; control: n = 87). The intervention consisted of a 1-year lifestyle programme focusing on diet (largely plant-based; strongest emphasis), physical activity, stress management, and social support. High-sensitivity C-reactive protein (hs-CRP) was assessed at baseline, 10 weeks, 6 months, and 1 year. Homocysteine (Hcy) was assessed at baseline, 10 weeks, and 1 year. Adiponectin (Apn) was assessed at baseline and 10 weeks. An exploratory analysis of these inflammatory markers assessing the between-group differences with ANCOVA was conducted.ResultsThe 1-year trajectory of hs-CRP was significantly lower in the intervention group compared to control (between-group difference: -0.8 (95% CI -1.2, -0.3) mg/l; p = 0.001; adjusted for baseline). The 1-year trajectory of Hcy was non-significantly higher in the intervention compared to control (between-group difference: 0.2 (95% CI -0.3, 0.7) µmol/l; p = 0.439; adjusted for baseline). From baseline to 10 weeks, Apn decreased significantly more in the intervention group compared to control (between-group difference: -1.6 (95% CI -2.7, -0.5) µg/ml; p = 0.004; adjusted for baseline).ConclusionsOur study shows that healthy lifestyle changes can lower hs-CRP and Apn levels and are unlikely to significantly affect Hcy levels within 1 year.Trial registrationGerman Clinical Trials Register (DRKS; reference: DRKS00018775, registered 12 Sept 2019; retrospectively registered; www.drks.de).

First Aid Medication and Remedies for Heart Failure

Dear reader, this article provides information about the drugs used in heart failure, one of the diseases that are currently common ingangj . For most people, Heart Failure is a long-term condition that cannot be treated. But treatment can help keep symptoms under control, possibly for many years. The main treatment options are: healthy lifestyle changes , medications , devices installed on your chest to control heart rhythm, surgery . In most cases, a combination of treatment is required. Highlights: Heart failure is a common long-term condition that can be managed with treatment. Treatment options include medications, healthy lifestyle changes, devices for heart rhythm control, and surgery. A combination of treatments is often necessary to effectively manage heart failure. Keywords: Heart failure, Treatment options, Medications, Healthy lifestyle changes, Devices

Dietary advice in diabetes mellitus.

Dietary advice in diabetes mellitus.

Abnormal electrocardiogram or echocardiogram as interim measures for CVD risk stratification in pregnancy and postpartum

Cardiovascular disease (CVD) is the leading cause of maternal mortality in the United States. The diagnosis of CVD is challenging as signs and symptoms of normal pregnancy may mimic CVD. The California Maternal Quality Care Collaborative (CMQCC) CVD risk assessment algorithm was used to help stratify pregnant and postpartum patients into low or high risk for CVD and guide further cardiac testing. We sought to evaluate the intermediate outcomes, i.e., abnormal electrocardiogram (EKG) and echocardiogram, as surrogates for CVD to assess the positive predictive value of the CMQCC tool in patients determined to be at high risk for CVD. Retrospective medical record review of 1,399 patients that underwent CVD risk stratification using the CMQCC algorithm over an 18-month period at a major hospital network in California. The primary outcome was the rate of abnormal EKG or echo, defined as abnormal cardiac structure and/or function, among patients who were determined to be at increased risk for CVD. Of 29 patients identified to be at increased risk, 20 received follow-up testing with EKG or echo within 60 days of the risk assessment. Over half (65%) of the patients were found to have underlying EKG or echo abnormality. Abnormal cardiovascular testing results included findings such as sinus tachycardia (HR > 100 bpm), conduction delays, Wolff Parkinson-White syndrome, left ventricular hypertrophy/diastolic dysfunction, and chamber dilation. Using these results as a surrogate for CVD, the CMQCC risk assessment tool identified 13 cases of previously undiagnosed cardiovascular dysfunction in the study population (Table 1). Use of the CMQCC CVD risk assessment tool provides an opportunity for early diagnosis of CVD that may allow for prompt clinical intervention in addition to patient education and promotion of healthy lifestyle changes. EKG and echo results may be used as intermediate outcomes to assess the positive predictive value of the tool. Future long-term studies should evaluate the benefits of obstetric CVD risk assessment on the prevention of CVD over the life course.

Erratum: The effect of cancer diagnosis in first-degree relatives on participation of healthy individuals in cancer screening programs and on their attitudes towards healthy lifestyle changes

Erratum: The effect of cancer diagnosis in first-degree relatives on participation of healthy individuals in cancer screening programs and on their attitudes towards healthy lifestyle changes

Changes in lifestyle behaviors during the COVID-19 pandemic in children and adolescents with congenital heart disease.

To describe the changes in lifestyle behaviors during the COVID-19 pandemic in children and adolescents with congenital heart disease and to investigate the association of congenital heart disease complexity with lifestyle behavior changes. Cross-sectional study with 127 children and adolescents with congenital heart disease, who underwent cardiac procedure (mean postoperative time: 10.11±3.13 years), conducted between December 2020 and January 2021. Lifestyle behaviors, such as dietary intake, physical activity, sedentary behavior, and sleep, were assessed through telephone interview based on validated questionnaires. Dietary patterns were identified using principal component analysis. Frequency of general and specific combinations of healthy and unhealthy lifestyle behavior changes was evaluated. Multinomial logistic regressions were used to test the association between congenital heart disease complexity and changes in lifestyle behavior. The main lifestyle behaviors acquired during pandemic were: 83.5% decreased physical activity; 37.0% increased sedentary behavior; 26.0% slept more than usual; and 23.6% adopted a less-healthy dietary pattern. Almost half of the participants (41.8%) had at least one unhealthy change in lifestyle behavior. Complex congenital heart diseases were associated with increased sedentary behavior (OR 3.49, 95%CI 1.23-9.90). Children and adolescents with congenital heart disease had unhealthy lifestyle behavior during the pandemic, mainly in the form of reduced physical activity and increased sedentary behavior.

Understanding the Underlying Mechanisms of Action for Successful Implementation of Social Prescribing

There is growing evidence for the use of social prescribing as a means of facilitating healthy lifestyle behavior changes by linking patients to sources of support in the community. However, there are gaps in understanding about what works to facilitate and enable this behavior change i.e. , the mechanisms of actions underpinning social prescribing delivery. This study used a qualitative approach involving interviews with 18 Social Prescription Link Workers (SPLWs). Reflective thematic analysis was used to analyze the data. Through this, an overall theme of “Theoretical underpinning: Solution-focused and strengths-based” was identified. This was made up of sub-themes relating to mechanisms underpinning: the SPLWs’ role (comprising asking questions, motivational interviewing and the therapeutic alliance); the patients’ role, (empowerment and active engagement); and the approach adopted (solution building, goal and action orientated). To formalize this, a framework could be developed for SPLWs that encapsulates the solution-focused strengths-based approach for application within social prescribing. This framework can then be embedded into practice facilitating more successful healthy lifestyle behavior change for social prescribing patients.

ADDRESSING COVID-19 HEALTH DISPARITIES THROUGH VIRTUAL EDUCATION AND COLLABORATION

Abstract The South Side of Chicago, made up of predominantly Black and Latinx neighborhoods, has higher rates of COVID-19 infection and death rates and lower COVID-19 vaccination rates than other areas of Chicago. People aged 65 and older comprise nearly 15% of the region’s population. The SHARE Network at the University of Chicago has a long history of providing healthy aging education to organizations serving older adults on Chicago’s South Side. Using this pre-existing curricular structure, investigators created a monthly virtual workshop for community members to address COVID-19 related health disparities for older adults. Topics address aging concerns (i.e. dementia, mobility) and pandemic concerns (i.e. health disparities, vaccine hesitancy). At the end of the sessions, participants can ask questions to experts and share resources. Attendance has ranged from 15-20 participants, predominantly formal and informal caregivers. In post-attendance surveys, 80% of respondents identified as Black or African-American. Of the 20 respondents, 95% felt more knowledgeable about the topics discussed and all felt more knowledgeable about local health resources. Three-quarters felt more confident in the caregiving role, and 95% planned to make healthy lifestyle changes to benefit themselves or a loved one (i.e. more exercise, seeking respite care). These results demonstrate the positive impact of a timely community-informed virtual workshop. Providing virtual education on COVID-19 and healthy aging directly to older adult-focused community organizations and their clients is an early step health systems can take to address health disparities.

Use of an Interactive Obesity Treatment Approach in Individuals With Severe Mental Illness: Feasibility, Acceptability, and Proposed Engagement Criteria.

Digital and mobile health interventions are increasingly being used to support healthy lifestyle change, including in certain high-risk populations such as those with severe mental illnesses (SMIs). Life expectancy in this population lags 15 years behind counterparts in the general population, primarily due to obesity-related health conditions. We tested the feasibility and usability of a 12-week interactive obesity treatment approach (iOTA) to adults with chronic SMIs (depression, bipolar disorder and schizophrenia spectrum disorder) receiving treatment in community settings. The iOTA incorporates short message service (SMS) text messages to supplement monthly in-person health coaching. Factors hypothesized to be associated with weight change were illness severity and treatment engagement. Severe psychiatric symptoms were defined as baseline Clinical Global Impression severity score of >5. Criterion engagement was defined as a text messaging response rate >80% during the first 4 weeks of treatment. Disordered eating, assessed with the Loss of Control Over Eating Scores, was also evaluated. Participants provided qualitative data, further informing assessment of intervention feasibility, usability, and acceptability. A total of 26 participants were enrolled. The mean age was 48.5 (SD 15.67) years; 40% (10/26) were Black and 60% (15/26) female. Participants with lower symptom severity and adequate engagement demonstrated significantly decreased weight (F1,16=22.54, P<.001). Conversely, high symptom severity and lower text message response rates were associated with trend-level increases in weight (F1,7=4.33, P=.08). Loss-of-control eating was not observed to impact treatment outcome. Participants voiced preference for combination of live health coaching and text messaging, expressing desire for personalized message content. These results demonstrate the feasibility of delivering an adapted iOTA to SMI patients receiving care in community settings and suggest testable criteria for defining sufficient treatment engagement and psychiatric symptom severity, two factors known to impact weight loss outcomes. These important findings suggest specific adaptations may be needed for optimal treatment outcomes in individuals with SMI.

Current status of health promotion in Korea

Background: Health promotion can be defined as a process that allows individuals to control and improve their health. However, the term health promotion is used narrowly, it focuses on healthy lifestyle changes and behavioral risk factors such as nutrition, exercise, and stress management. Health promotion involves not only medicine and health but also a wide range of related areas such as policies, finances, and climate change measures. Nonetheless the medical field continues to play a/the leading role in health promotion.Current Concepts: The Korean government’s comprehensive national health promotion plan has implemented mid-to long-term health promotion policies under the National Health Promotion Act. From 2002, this project establishes a new goal every 10 years and prepares a supplementary plan every five years. Another initiative is the community health survey by the Korea Disease Control and Prevention Agency, which has been conducted since 2007. This survey provides data on basic health behavior and status, including physical measurement, smoking, obesity, drinking, diet, medicine use, disease, vaccination, health knowledge, accidents, and visits to medical institutions. Research on health promotion in Korea is available from the KoreaMed database.Discussion and Conclusion: While Korea’s health promotion status has seen rapid improvement in the past, the degree of improvement has recently been marginal and risks stagnating, the degree of improvement has recently been marginal and risks stagnating and the role of medical professionals is an essential.

Deep Learning for Predicting Congestive Heart Failure

Congestive heart failure (CHF) is one of the most debilitating cardiac disorders. It is a costly disease in terms of both lives and financial outlays, given the high rate of hospital re-admissions and mortality. Heart failure (HF) is notoriously difficult to identify on time, and is frequently accompanied by additional comorbidities that further complicate diagnosis. Many decision support systems (DSS) have been developed to facilitate diagnosis and to raise the standard of screening and monitoring operations, even for non-expert staff. This is confirmed in the literature by records of highly performing diagnosis-aid systems, which are unfortunately not very relevant to expert cardiologists. In order to assist cardiologists in predicting the trajectory of HF, we propose a deep learning-based system which predicts severity of disease progression by employing medical patient history. We tested the accuracy of four models on a labeled dataset, composed of 1037 records, to predict CHF severity and progression, achieving results comparable to studies based on much larger datasets, none of which used longitudinal multi-class prediction. The main contribution of this work is that it demonstrates that a fairly complicated approach can achieve good results on a medium size dataset, providing a reasonably accurate means of determining the evolution of CHF well in advance. This potentially constitutes a significant aid for healthcare managers and expert cardiologists in designing different therapies for medication, healthy lifestyle changes and quality of life (QoL) management, while also promoting allocation of resources with an evidence-based approach.

Healthy diets, lifestyle changes and well-being during and after lockdown: longitudinal evidence from the West Midlands

Background‘Lockdowns’ to control the spread of COVID-19 in the UK affected many aspects of life and may have adversely affected diets. We aimed to examine (1) the effect of lockdowns...

Real-Time Continuous Glucose Monitoring in Adolescents and Young Adults With Type 2 Diabetes Can Improve Quality of Life.

Real-time continuous glucose monitoring (CGM) is effective for diabetes management in cases of type 1 diabetes and adults with type 2 diabetes (T2D) but has not been assessed in adolescents and young adults (AYAs) with T2D. The objective of this pilot interventional study was to assess the feasibility and acceptability of real-time CGM use in AYAs with T2D. Adolescents and young adults (13-21 years old) with T2D for six months or more and hemoglobin A1c (A1c) greater than 7%, on any Food and Drug Administration-approved treatment regimen, were included. After a blinded run-in period, participants were given access to a real-time CGM system for 12 weeks. The use and acceptability of the real-time CGM were evaluated by sensor usage, surveys, and focus group qualitative data. Participants' (n = 9) median age was 19.1 (interquartile range [IQR] 16.8-20.5) years, 78% were female, 100% were people of color, and 67% were publicly insured. Baseline A1c was 11.9% (standard deviation ±2.8%), with median diabetes duration of 2.5 (IQR 1.4-6) years, and 67% were using insulin. Seven participants completed the study and demonstrated statistically significant improvement in diabetes-related quality of life, with the mean Pediatric Quality of Life inventory (PedsQL) diabetes score increasing from 70 to 75 after using CGM (P = .026). Focus group results supported survey results that CGM use among AYAs with T2D is feasible, can improve quality of life, and has the potential to modify behavior. Real-time CGM is feasible and acceptable for AYAs with T2D and may improve the quality of life of patients with diabetes. Larger randomized controlled trials are needed to assess the effects on glycemic control and healthy lifestyle changes.

A Rapid Review of the Impact of Family-Based Digital Interventions for Obesity Prevention and Treatment on Obesity-Related Outcomes in Primary School-Aged Children.

Virtual delivery of obesity prevention and treatment programs may be effective for supporting children and families to adopt healthy lifestyle changes while enhancing program accessibility. This rapid review aimed to summarize the impact of family-based digital interventions for childhood obesity prevention and treatment. Four databases were searched up to February 2021 for trials of interactive digital programs aimed to prevent and/or treat obesity in children aged 5-12 years and reported diet, physical activity, sedentary behavior, sleep, or weight-related outcomes in children. A total of 23 publications (from 18 interventions) were included. Behavior change theories were used in 13 interventions with "Social Cognitive Theory" applied most frequently (n = 9). Interventions included websites (n = 11), text messaging (n = 5), video gaming (n = 2), Facebook (n = 3), and/or mobile applications (n = 2). Studies reported changes in body mass index (BMI; n = 11 studies), diet (n = 11), physical activity (n = 10), screen time (n = 6), and/or sleep (n = 1). Significant improvements were reported for diet (n = 5) or physical activity (n = 4). Two of the six interventions were effective in reducing screen time. Digital interventions have shown modest improvements in child BMI and significant effectiveness in diet and physical activity, with emerging evidence supporting the use of social media and video gaming to enhance program delivery.

Co-designing Healthy Living after Cancer Online: an online nutrition, physical activity, and psychosocial intervention for post-treatment cancer survivors

PurposeThe aim of the present study was to co-design Healthy Living after Cancer Online (HLaC Online), an online intervention supporting cancer survivors to set and meet their healthy living goals.MethodsAdapted from an initial telephone-delivered Healthy Living after Cancer program, wireframes (PDF black and white mock-ups) of the proposed online program were presented in a series of focus groups and interviews to our stakeholder group, which consisted of cancer survivors, oncology healthcare professionals, and representatives from cancer support organisations. Stakeholders were prompted for feedback on the wireframe and given end-user scenarios to encourage deeper engagement with the co-design process. Transcriptions underwent thematic analysis to determine which features of the program needed change or expansion.Results27 participants took part in one of 8 focus groups or 10 interviews. Five themes were identified relating to (a) website design elements, (b) promoting and maintaining long-term engagement, (c) relatability and relevance, (d) navigating professional support, and (e) family and peer support. Recommended changes, such as simple activities and guidance videos, were integrated into the HLaC Online prototype.ConclusionsInvolving end-users in the co-design process ensured the intervention’s relevance and specificity to the needs of cancer survivors. Next steps include feasibility testing the prototype, prior to commencing a national randomised control trial of HLaC Online.Implications for Cancer SurvivorsHLaC Online aims to support cancer survivors to improve their quality of life by making healthy lifestyle changes in their physical activity, healthy eating, weight management, mental health, and fatigue management.

The Preventive Effects of Urtica dioica ‎Extract and Nanoparticle on Oxidative Stress ‎and Lipid Profile in Hyperlipidemic Male ‎Rats

Cardiovascular diseases are the major factor in human premature death and disability and they are becoming more common worldwide. Individual atherosclerosis risk factors such obesity, hypertension, hyperlipidemia, diabetes, and smoking all lead to an increase in oxidative stress. As a result, oxidative stress is thought to be a major factor in the development of atherosclerosis. Heart disease risk factors that have been well-documented include elevated blood lipid levels. Significant gaps in the treatment of CVDs still exist, in addition to making healthy lifestyle changes and using lipid-lowering medications as part of primary CVD prevention and therapy regimens. Natural extracts are a rich source of biomolecules that can be used as complex reagents for the biogenic synthesis of silver nanoparticles as well as antioxidant medicines or dietary supplements. The current study estimates the anti-oxidant and protective activity of Urica dioica 200mg/kg extract water and ethanol with its silver nanoparticles 15mg/kg on lipid profile in induced hyperlipidemia rats feeding on high fat diet then evaluate lipid profile and MDA, SOD and GSH of the serum after 40 days, also characterization of AgNPs done by UV-Vis absorption, FTIR, XRD and SEM. The result demonstrates that the successful synthesis of NPs and Urtica dioica has a favorable impact on lipid profile and can function as a good antioxidant that can be employed as a protective agent against rising lipids and oxidative stress. However, further research studies need to investigate the safety and activity of different dose of AgNPS of Urtica dioica.

Relationships Between Blood Pressure Reduction, Weight Loss, and Engagement in a Digital App-Based Hypertension Care Program: Observational Study.

Home blood pressure (BP) monitoring is recommended for people with hypertension; however, meta-analyses have demonstrated that BP improvements are related to additional coaching support in combination with self-monitoring, with little or no effect of self-monitoring alone. High-contact coaching requires substantial resources and may be difficult to deliver via human coaching models. This observational study assessed changes in BP and body weight following participation in a fully digital program called Lark Hypertension Care with coaching powered by artificial intelligence (AI). Participants (N=864) had a baseline systolic BP (SBP) ≥120 mm Hg, provided their baseline body weight, and had reached at least their third month in the program. The primary outcome was the change in SBP at 3 and 6 months, with secondary outcomes of change in body weight and associations of changes in SBP and body weight with participant demographics, characteristics, and program engagement. By month 3, there was a significant drop of -5.4 mm Hg (95% CI -6.5 to -4.3; P<.001) in mean SBP from baseline. BP did not change significantly (ie, the SBP drop maintained) from 3 to 6 months for participants who provided readings at both time points (P=.49). Half of the participants achieved a clinically meaningful drop of ≥5 mm Hg by month 3 (178/349, 51.0%) and month 6 (98/199, 49.2%). The magnitude of the drop depended on starting SBP. Participants classified as hypertension stage 2 had the largest mean drop in SBP of -12.4 mm Hg (SE 1.2 mm Hg) by month 3 and -13.0 mm Hg (SE 1.6 mm Hg) by month 6; participants classified as hypertension stage 1 lowered by -5.2 mm Hg (SE 0.8) mm Hg by month 3 and -7.3 mm Hg (SE 1.3 mm Hg) by month 6; participants classified as elevated lowered by -1.1 mm Hg (SE 0.7 mm Hg) by month 3 but did not drop by month 6. Starting SBP (β=.11; P<.001), percent weight change (β=-.36; P=.02), and initial BMI (β=-.56; P<.001) were significantly associated with the likelihood of lowering SBP ≥5 mm Hg by month 3. Percent weight change acted as a mediator of the relationship between program engagement and drop in SBP. The bootstrapped unstandardized indirect effect was -0.0024 (95% CI -0.0052 to 0; P=.002). A hypertension care program with coaching powered by AI was associated with a clinically meaningful reduction in SBP following 3 and 6 months of program participation. Percent weight change was significantly associated with the likelihood of achieving a ≥5 mm Hg drop in SBP. An AI-powered solution may offer a scalable approach to helping individuals with hypertension achieve clinically meaningful reductions in their BP and associated risk of cardiovascular disease and other serious adverse outcomes via healthy lifestyle changes such as weight loss.

Heart rate variability and the risk of heart failure and its subtypes in post-menopausal women: The Women's Health Initiative study.

BackgroundLow heart rate variability (HRV), a measure of autonomic imbalance, is associated with increased risk of coronary heart disease (CHD) and heart failure (HF). However, its relationship with HF subtypes; heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) has not been studied prior.Methods and findingsWe conducted a longitudinal study in Women’s Health Initiative study cohort to investigate the association of baseline quartiles of resting heart rate (rHR) and HRV measures; SDNN (SD of normal-to-normal RR interval) and RMSSD (root mean square of successive difference of RR interval) measured by twelve-lead electrocardiogram (ECG) on enrollment, with the risk of hospitalized HF and its subtypes. Total of 28,603 post-menopausal women, predominantly non-Hispanic whites (69%), with a mean (SD) age of 62.6 (7.1) years, free of baseline CHD and HF were included. In a fully adjusted cox-proportional hazards regression model which adjusted for age, race, BMI, alcohol intake, education, physical activity, hyperlipidemia, hypertension, left ventricular hypertrophy, use of beta-blocker, calcium-channel blocker, hormone therapy, and time-varying incident CHD, the hazard ratios of lowest quartile of HRV (Q1) with HF risk were significant (Q1 SDNN compared to Q4 SDNN: 1.22, 95% CI 1.07, 1.39; Q1 RMSSD compared to Q4 RMSSD: 1.17, 95% CI 1.02, 1.33). On subgroup analysis of HF subtypes, low HRV was associated with elevated HFpEF risk (Q1 vs Q4 SDNN: 1.22, 95% CI 1.02, 1.47) but not with HFrEF (Q1 vs Q4 SDNN: 1.19, 95% CI 0.95, 1.50; Q1 RMSSD: 1.13, 95% CI 0.90, 1.43).ConclusionLow HRV is associated with elevated overall hospitalized HF risk and HFpEF risk in post-menopausal women. Whether interventions to increase HRV through healthy lifestyle changes will decrease HF risk warrants further investigation.