Infrequent Exercise Research Articles

The impact of pre-myocardial infarction exercise frequency on prognosis in Non-ST segment elevation myocardial infarction patients

Abstract Background Non-ST segment elevation myocardial infarction (NSTEMI) presents a significant challenge in cardiovascular care, often requiring urgent management. Understanding the impact of exercise frequency prior to the onset of NSTEMI on post-event prognosis is crucial for developingmedical strategies. Purpose This study aimed to investigate the clinical characteristics and outcomes of NSTEMI patients based on their exercise frequency before experiencing NSTEMI, comparing those with regular exercise (once or more per week) versus those with infrequent or no exercise. Methods This study included acute myocardial infarction cohorts from 71 secondary or tertiary hospitals between January 1, 2010 and June 30, 2023. Inclusion criteria comprised NSTEMI patients evaluated for exercise frequency using the Community Health Questionnaire before hospitalization. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), net adverse clinical events (NACE), and all-cause mortality, with secondary outcomes comprising the individual components of MACCE and NACE. Propensity score matching (PSM) was employed to adjust for differences in clinical characteristics between the two groups. Multivariable Cox regression and robust multivariable Cox regression were conducted before and after PSM to evaluate the impact of exercise frequency on outcomes. Results The final study population consisted of 38753 participants (42.7% in the High-frequency exercise group). The median follow-up duration was 1518 days, the mean age was 67.80±11.47 years, 61.6% were male. Compared to individuals with infrequent exercise before NSTEMI, those with regular exercise exhibited significantly lower risks of MACCE [aHR 0.93(0.90-0.96), p<0.001], NACE [aHR 0.91(0.88-0.95), p<0.001], and all-cause mortality [aHR 0.88(0.85-0.92), p<0.001]. However, regular exercise before NSTEMI was associated with an increased risk of coronary revascularization [aHR 1.14(1.06-1.23), p<0.001]. These findings remained consistent in the robust multivariate Cox regression analysis conducted after adjusting for differences between the two groups with PSM (Figure 1). After PSM, survival analysis indicated that the incidence of primary outcomes was lower in individuals with high exercise frequency before NSTEMI compared to those with low exercise frequency before NSTEMI, with all-cause mortality rates of 26.9% vs. 30.8%, MACCE rates of 37.2% vs. 38.5%, and NACE rates of 37.9% vs. 39.1%, all with log-rank p-values <0.001. Conclusion This study highlights the protective role of regular physical activity befor NSTEMI in reducing adverse post-NSTEMI outcomes. Promoting pre-NSTEMI physical activity can be a key element in preventive cardiology, potentially improving prognosis and decreasing the likelihood of cardiovascular events post-NSTEMI.Figure 1

The impact of pre-myocardial infarction exercise frequency on prognosis in acute myocardial infarction patients

Abstract Background Acute myocardial infarction (AMI) is a critical cardiovascular event often associated with significant morbidity and mortality. Despite the acknowledgment of regular physical activity as vital for cardiovascular health, its influence on post-AMI prognosis in patients with varying pre-AMI exercise frequencies remains to be fully explored. Purpose This study aimed to investigate the outcomes of AMI patients based on their exercise frequency prior to the occurrence of AMI, comparing those with regular exercise (once or more per week) versus those with infrequent or no exercise. Methods This study included acute myocardial infarction cohorts from 71 secondary or tertiary hospitals between January 1, 2010 and June 30, 2023. Inclusion criteria comprised AMI patients evaluated for exercise frequency using the Community Health Questionnaire before hospitalization. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE), net adverse clinical events (NACE), and all-cause mortality, with secondary outcomes comprising the individual components of MACCE and NACE. Propensity score matching (PSM) was employed to adjust for differences in clinical characteristics between the two groups. Multivariable Cox regression and robust multivariable Cox regression were conducted before and after PSM to evaluate the impact of exercise frequency on outcomes. Results The final study population consisted of 77,427 participants (42.1% in the High-frequency exercise group). The median follow-up duration was 1595 days, the mean age was 66.03±11.82 years, 65.6% were male. Compared to individuals with infrequent exercise before AMI, those with regular exercise exhibited significantly lower risks of MACCE [aHR 0.93 (0.91-0.96), p<0.001], NACE [aHR 0.91 (0.89-0.93), p<0.001], and all-cause mortality [aHR 0.90 (0.87-0.92), p<0.001]. However, regular exercise before AMI was associated with an increased risk of coronary revascularization [aHR 1.12 (1.07-1.17), p<0.001]. These findings remained consistent in the robust multivariate Cox regression analysis conducted after adjusting for differences between the two groups with PSM (Figure 1). After PSM, survival analysis indicated that the incidence of primary outcomes was lower in individuals with high exercise frequency before AMI compared to those with low exercise frequency before AMI, with all-cause mortality rates of 23.1% vs. 35.4%, MACCE rates of 26.4% vs. 36.2%, and NACE rates of 36.9% vs. 36.2%, all with log-rank p-values <0.001. Conclusions This study underscores the protective role of regular physical activity prior to AMI in reducing adverse post-AMI outcomes. Promoting pre-AMI physical activity can be a key element in preventive cardiology, potentially improving prognosis and decreasing the likelihood of cardiovascular events post-AMI.Figure 1

Investigation of Factors Associated with Gut Microbiota in Demodex-associated Skin Conditions.

This study describes the relationships of factors related to gut microbiota and skin conditions associated with Demodex, including demodicosis, rosacea, and perioral dermatitis. A total of 113 patients from Dokuz Eylül University Hospital Dermatology Department answered a cross-sectional questionnaire. They consisted of 42 cases of Demodex-related skin diseases and 71 healthy controls. Demographic data and medical history, dietary and lifestyle habits, and gastrointestinal symptoms were recorded. Statistical analysis included descriptive statistics, chi-square tests, Fisher's Exact tests, independent samples t-tests, and logistic regression methods. Our findings identified alcohol consumption [odds ratio (OR)=11.13, 95% confidence interval (CI): 4.11-17.22, p<0.01] and smoking (OR=10.32, 95% CI: 2.47-21.57, p<0.01) as strong risk factors for Demodex-related conditions. Low water intake (0-1 liter per day) (OR=3.39, 95% CI: 2.08-5.57, p=0.03) and infrequent exercise (less than 1 hour per week) (OR=4.87, 95% CI: 2.70-12.54, p=0.02) were also significant risk factors. Additional factors associated with increased Demodex risk included reduced bowel movements (OR=2.71, 95% CI: 1.45-4.06, p=0.01) and higher pet ownership (OR=2.85, 95% CI: 2.13-4.27, p=0.03). Although vegetarian and high-fat diets showed some associations, they were not independently significant. This study demonstrates key environmental and lifestyle factors, such as low water intake, infrequent exercise, reduced bowel movements, higher pet ownership, alcohol consumption, and smoking, that are significantly associated with Demodex-related skin conditions. These factors, related to gut microbiota, may provide valuable insights for managing these skin conditions and suggest promising directions for future research.

The Influence of Lifestyle on Cholesterol Levels

The Epidemic of Non-Communicable Diseases (NCD) Obesity has doubled since the 1980s, rapidly becoming the largest global public health challenge. Obesity is the third leading cause of death in the world. The increase in obesity rates is associated with an individual's habit of consuming food with more energy than the body needs. Risk factors that can influence the increase in the prevalence of heart disease involve individuals with hypertension, diabetes mellitus, dyslipidemia, lack of physical activity, poor lifestyle habits such as consuming fast food, an unhealthy diet, and experiencing prolonged stress. This can be changed with a better lifestyle, while some risks that cannot be changed are congenital or genetic heart disease. Research Objective: reduce the death rate caused by heart disease by reducing the risk of heart disease. The sampling technique used is random sampling with a cross-sectional approach, and the examination sample consists of capillary blood, measurements, and interviews using questionnaires. Out of 130 people in Nisa Village, a significant relationship was found between an increase in cholesterol levels and respondents who frequently consume fast food. Subjects who were active/passive smokers had a significance value of 0.65 (p&gt;0.05), indicating a strong relationship according to correlation guidelines. Subjects who frequently experienced stress also had a strong relationship with an increase in blood cholesterol levels, with a significance value of 0.34 (p&gt;0.05). The variable of subjects who rarely exercised was found to have a significance value of 0.38 (p&gt;0.05), meaning that the habit of infrequent exercise has a strong relationship with an increase in cholesterol levels.

Understanding Minangkabau Culture and its Impact on Weight Management Strategies in Overweight and Obese Women: A Qualitative Study

Background Overweight and obesity have a particular impact on women; thus, overweight and obese women need to modify their lifestyle in order to lose weight. Diet and exercise are part of the lifestyle influenced by the values of society. Objective This study aimed to explore the influence of Minangkabau cultural values on weight management strategies among obese women, aiming to identify culturally appropriate interventions. Methods The data were collected through Focus Group Discussions (FGDs) and semi-structured interviews between 35 overweight and obese women, two Minangkabau community leaders, and three health workers in Solok, West Sumatra Province, from June to December 2022. The data were analysed using a descriptive-qualitative approach with thematic content analysis and Colaizzi’s method. Results Our analysis revealed three primary themes: eating habits being more desire-driven, less nutritious, and irregular; infrequent exercise due to physical and psychosocial barriers; and significant challenges in weight management due to social and cultural values. Conclusion The study highlights the profound influence of Minangkabau cultural values on diet and exercise habits among overweight and obese women, including foods containing coconut milk and fried foods served as the daily menu at home and traditional events; behavioural rules for women to dress without revealing their curves; the prohibition to exercise in public and walk alone; and the significance of obesity as a symbol of prosperity. There is a need for a strategy to encourage healthy diet and exercise habits in society in accordance with the Minangkabau cultural values for women. A support group consisting of numerous obese women, their families, and community leaders is also required.

Literature Review: Relationship of Lifestyle with Incidence of Primary Dysmenorrhea in College Students

Introduction: Menstruation is periodic and cyclic bleeding from the uterus, accompanied by endometrial desquamation. In specific individuals, menstruation can cause pain called dysmenorrhea, which is characterized by mild, moderate, and severe menstrual pain. Primary dysmenorrhea is not a life-threatening disorder, but it can hurt women's quality of life. Prevalence of menopause in Indonesia An estimated 55% of women of reproductive age experience pain during menstruation. Material and Methods: We searched articles published from 2014-2020 in PubMed, Proquest, and Google Scholar with the keywords "primary dysmenorrhea” AND “student lifestyle”. All data were gathered and analyzed. Results: The results showed that 8 articles showed the relationship between lifestyle and the occurrence of primary menstrual pain among female students. In comparison, the other two articles show that there is no relationship between lifestyle and primary dysmenorrhea in female students. Conclusion: This study concludes that an unhealthy lifestyle, such as high stress levels, infrequent exercise, and frequent consumption of fast food, is effective for primary dysmenorrhea during menstruation.

Beneficial Effects of Preoperative Exercise on the Outcomes of Lumbar Fusion Spinal Surgery.

Purpose: To determine whether there was an association between self-reported preoperative exercise and postoperative outcomes after lumbar fusion spinal surgery. Method: We performed a retrospective multivariable analysis of the prospective Canadian Spine Outcomes and Research Network (CSORN) database of 2,203 patients who had elective single-level lumbar fusion spinal surgeries. We compared adverse events and hospital length of stay between patients who reported regular exercise (twice or more per week) prior to surgery ("Regular Exercise") to those exercising infrequently (once or less per week) ("Infrequent Exercise") or those who did no exercise ("No Exercise"). For all final analyses, we compared the Regular Exercise group to the combined Infrequent Exercise or No Exercise group. Results: After making adjustments for known confounding factors, we demonstrated that patients in the Regular Exercise group had fewer adverse events (adjusted odds ratio0.72; 95%CI: 0.57,0.91; p=0.006) and significantly shorter lengths of stay (adjusted mean2.2 vs. 2.5 d, p=0.029) than the combined Infrequent Exercise or No Exercise group. Conclusions: Patients who exercised regularly twice or more per week prior to surgery had fewer postoperative adverse events and significantly shorter hospital lengths of stay compared to patients that exercised infrequently or did no exercise. Further study is required to determine effectiveness of a targeted prehabilitation programme.

Design and implementation of an Internet-Based cancer risk assessment tool: Use over 10 years.

Prevention and early intervention can improve survival and quality of life across all cancers. Patient understanding of risk factors and associated actionable lifestyle changes and screening programs is not well understood by clinicians METHODS: An Internet-based tool, Reduce My Risk, was created in 2009 and made available on oncolink.org. Users voluntarily completed a survey regarding demographics and cancer risk factors, and received information about their cancer risk RESULTS: Twenty eight thousand and one surveys were completed from 2009 to 2019. Median age was 26 years (18-101); 60% were females, 87% lived in North America, and 37% had at least a bachelor's degree. Users reported on behavioral/ modifiable risk factors: 13% were current smokers, 52% were current consumers of alcohol, and 8% of those had ≥14 drinks/week. Body mass index (BMI) was ≥30 in 19%; 74% of all surveys reported dietary risks and 36% reported infrequent exercise. Excess UV exposure was reported by 19%. Among women, 36% reported performing breast self-examinations monthly, and 50% reported receiving clinician breast examinations at least once every 3 years. Sixty seven percent of men 55-75 years reported screening prostate specific antigen testing, with 50% receiving annual digital rectal examinations. Nonmodifiable risk factors included family cancer history (64%), genetic syndrome (3%), and cancer-predisposing health conditions (26%) CONCLUSIONS: Ninety-seven percent of users reported modifiable risk factors, and 60% reported ≥4 of these risk factors. Understanding detailed characteristics of a large number of respondents has the potential to improve educational interventions to reduce cancer risk through behavioral modification and cancer screening across the general public.

Prevalence of depression and anxiety and their predictors among patients undergoing maintenance hemodialysis in Northern China: a cross-sectional study

Objective To investigate the prevalence of depression and anxiety in patients undergoing maintenance hemodialysis (MHD) in Hohhot, a large city on the northern border of China, and to identify independent risk factors for depression and anxiety in these patients. Methods Patients receiving MHD for >3 months were enrolled in the four largest hemodialysis centers between September 2020 and December 2020. Depression and anxiety were assessed using the Zung self-rated depression scale (SDS) and Zung self-rated anxiety scale (SAS), respectively, with demographic and other data collected for logistic regression analyses. Results Among 305 MHD patients included in this study, the prevalence of depression was 55.1%, including 27.5%, 21.0%, and 6.6% with mild, moderate and severe cases, respectively. The prevalence of anxiety was 25.9%, with 20.0%, 4.6%, and 1.3% having mild, moderate, and severe cases, respectively. An independent protective factor for depression was family income of ≥1415 US dollars/month relative to <157 US dollars/month (odds ratio [OR] 0.209, 95% confidence interval [CI] 0.065–0.673), and predictors of depression included ≥3 comorbidities (OR 18.527, 95% CI 1.674–205.028) and severe pruritus (OR 15.971, 95% CI 5.173–49.315). Independent predictors of anxiety included infrequent exercise (OR 3.289, 95% CI 1.411–7.664) and severe pruritus (OR 5.912, 95% CI 1.733–20.168). The correlation between depression and anxiety in these patients was significant (rs = 0.775, p < 0.001). Conclusion MHD patients in Northern China had high prevalence rates of depression (55.1%) and anxiety (25.9%). Lower family income, more comorbidities, and a higher degree of pruritus were predictors of depression, while infrequent exercise and severe pruritus were predictors of anxiety. Depression correlated significantly with anxiety. Attention should be given to family income, comorbidity, exercise, and pruritus severity for improved management of depression and anxiety among MHD patients.

Abstract 16121: Wellness in Pediatric Cardiac Intensivists - How are We Doing?

Introduction: Poor physician wellness is associated with detrimental effects on patient outcomes. There are no data on physician wellness in pediatric cardiac critical care. We aimed to define the prevalence of and risk factors for impaired wellness using a targeted survey of the North American pediatric cardiac critical care workforce. Methods: We developed a survey to examine physician wellness and potential risk factors, incorporating the Expanded Physician Well Being Index. Unit directors at 120 congenital heart surgery centers were contacted to provide faculty emails. The survey was distributed to each faculty with targeted reminders from June - September 2019. Univariate and multivariable logistic regression analyses were performed comparing the at-risk respondents to those not at risk for poor wellness. Results: Of the 477 faculty, 294 completed the survey (62%). Faculty reported working a median of 83 hours on service weeks and 50 hours on non-service weeks. Based on Well-Being scores, 34% were in the “at risk” category; 56% reported feeling burned out in the past month and 46% reported feeling overwhelmed. However, 96% felt their work was meaningful. Faculty reported a high incidence of developing unhealthy habits including poor nutrition (50%), infrequent exercise (56%), and lack of self-care (46%). Factors associated with well-being risk are shown in Table 1. Poor interpersonal experiences, higher work hours, and being primarily trained in critical care with an additional cardiac year were associated with risk of poor wellness. Working &gt;100 hours per service week had a significant increase in risk (odds ratio 2.3, 95% confidence interval 1.31-4.40). Availability of wellness services was associated with reduced risk. Conclusion: Burnout and risk of poor wellness are common in pediatric cardiac critical care faculty. Modifiable factors, including wellness service availability and reduced hours of clinical service may improve wellness in the workforce.

Timed physical exercise does not influence circadian rhythms and glucose tolerance in rotating night shift workers: The EuRhythDia study

Objectives:Night shift workers are at cardiometabolic risk due to circadian misalignment. We investigated whether infrequent exercise before each night shift that intentionally would not improve physical performance improves glucose tolerance and 24-h blood pressure profiles and synchronizes circadian rhythms of melatonin and cortisol in rotating night shift workers.Methods:A total of 24 rotating night shift workers (mean age, 35.7 ± 11.8 years) were randomized to exercise or no intervention. Workers in the exercise group performed 15.2 ± 4.5 exercise sessions within 2 h before each night shift. Before and after 12 weeks of exercise intervention and 12 weeks after the intervention, spiroergometry, oral glucose tolerance testing and 24-h blood pressure profiles were performed. Plasma melatonin and cortisol levels were measured in 3-hourly intervals during one 24-h period on each study day.Results:Exercise did not significantly change serum glucose nor insulin levels during oral glucose tolerance testing. Timed physical exercise had no effect on physical performance, nor did it change the circadian rhythms of melatonin and cortisol or influence 24-h blood pressure profiles.Conclusion:Physical exercise before each night shift at a low intensity level that does not improve physical performance does not affect circadian timing, glucose tolerance or 24-h blood pressure profiles in rotating night shift workers.

Associations between high caffeine consumption, driving safety indicators, sleep and health behaviours in truck drivers

BackgroundTruck drivers are vulnerable to driver sleepiness due to pressures of shift work and prolonged driving hours; this is a safety concern as sleepiness more than doubles crash risk. Caffeine is a commonly used countermeasure to driver sleepiness. Previous research with truck drivers has demonstrated a positive impact of caffeine consumption on crash risk. However, habitual use of caffeine has the potential to impair night time sleep resulting in increased sleepiness and safety risk. One group that may be particularly vulnerable to the potential negative impacts of high caffeine consumption are those truck drivers who consume ≥ 5 caffeinated drinks per day (≥90th percentile American average daily caffeine consumption). Method1,653 self-reported low (1 caffeinated drink per day) and 1,354 high (≥5 caffeinated drinks per day) caffeine consumers were compared across a range of driving safety indicators, health and sleep variables. All drivers completed an initial background questionnaire including the Epworth Sleepiness Scale (ESS), Berlin Questionnaire (BQ) and Dula Dangerous Driving Index (DDDI). Crashes and driving violations were monitored for up to 3 years (depending on enrolment date). Medical Examination Reports were available for 83.0% of the 3,007 participants. ResultsHigh caffeine consumers were more likely to report poor sleep outcomes: shorter average sleep time, (7.08 h compared to 7.41 h), higher prevalence of excessive daytime sleepiness (7.5% compared to 5.7%) and higher proportion at high risk of obstructive sleep apnoea (OSA) on the BQ (13.1% compared with 9.4%). The higher caffeine consumers were more likely to report negative health behaviours: smoking, alcohol consumption, poor diet and infrequent exercise. Poorer driving safety indicators (negative emotions and aggressive driving on the DDDI) and previous crashes (27.8% compared to 21.6%) were also more common in high than low caffeine consumers. ConclusionCaffeine is an effective countermeasure to driver sleepiness, however, high caffeine consumers do not exhibit any benefit to driving safety indicators. In fact, there is some evidence for safety concern because high caffeine consumers self-report more crashes and worse driving safety indicators than low caffeine consumers. High caffeine consumption was associated with poor health behaviours. Further research is needed to fully understand the implications of high caffeine use. Interventions aiming to reduce truck driver sleepiness should be cautious in promotion of caffeine in isolation; a wholistic approach to improve driver health would likely be more effective than focusing on sleep health alone.

Working Memory in Collegiate Athletes and Non-Athletes: A Comparison of Team-Sports Athletes, Solo-Sports Athletes, Frequent Exercisers and Infrequent Exercisers

Past research suggests that exercise is associated with improved working memory (WM) abilities, and that athletes have better executive functioning and WM skills than non-athletes. However, no studies to date have separated the effects of exercise from the effects of athletic participation when examining WM. This study had three primary goals: (1) to determine whether amateur college athletes have better auditory and visual WM than their non-athlete peers who exercise frequently and whether non-athlete frequent exercisers have better WM than non-athlete infrequent exercisers (2) to determine whether amateur participation in particular types of sports (team-based versus solo sports) corresponds to differences in auditory or visual WM, and (3) to examine whether gender plays a role in the relationships between exercise, athletic participation and WM. This study was a cross-sectional, correlational design that examined WM in men versus women college students divided into four groups (team-sports athletes, solo-sports athletes, frequent exercisers, and infrequent exercisers). 153 college students completed five tests of auditory (Digit Span subtest, PASAT) and visual (Spatial Span subtest, N-Back, WCST) WM. Collegiate men who participated in team-based sports outperformed collegiate men who participated in solo-sports in auditory WM. The two non-athlete groups (frequent and infrequent exercisers) earned scores between those of the two athlete groups. Male infrequent exercisers demonstrated better visual WM than the other three male athlete/exerciser groups. In contrast, neither athletic participation nor exercise affected collegiate women’s WM abilities. Our results did not support our hypothesis that all types of student athletes would exhibit better WM than students who exercise regularly but do not engage in competitive sports. Additionally, our data did not indicate that frequent exercise is associated with stronger WM skills than infrequent exercise in non-athlete college students. Participation in team-based sports was associated with better auditory WM skills than participation in solo sports, but this was only true for male, not female, athletes. Thus, gender was an important factor in delineating the relationships between exercise, athletic participation and WM.

Design and implementation of an Internet-based cancer risk assessment tool: Use over 10 years.

e13075 Background: Prevention and early intervention can improve survival and quality of life across all cancers. Patient understanding of risk factors, and associated actionable lifestyle changes and screening programs, is not well understood by clinicians. Methods: The Internet-based OncoLink “Reduce My Risk” tool was created in 2009 to provide information about cancer risk after individuals responded to a comprehensive survey regarding demographics and cancer risk factors. Research related to these data has been IRB-approved. Results: 28,001 surveys were submitted. Median age among respondents ≥18y was 26y (18-101). 60% were female, 87% lived in North America, and 76% were White/Non-Hispanic. 37% had at least a bachelor’s degree, and 22% had household income &gt; $100,000/y; most lived in a city/suburb (81%). 13% were current smokers, 23% previous smokers, 10% used cigars or pipe tobacco (10%), 6% used oral snuff/chew/quid, and 29% reported secondhand smoke exposure. Other substance use included marijuana (22% former users, 10% current users), alcohol (52% current users, 8% of those ≥14 drinks/w), and areca nut, betel leaf, or exotic smoking (1%). BMI was ≥30 in 19%. 74% reported dietary risks and 36% infrequent exercise. Early intercourse and &gt; 10 sexual partners were reported by 43% and 10%, respectively. Excess UV exposure was reported by 19%, and exposure to known carcinogens 14%; 1% were exposed to DES in utero, and &lt; 1% took DES while pregnant. Nonmodifiable risk factors included family cancer history (64%) or genetic syndrome (3%), and cancer-predisposing health condition (26%). 31% of women began menstruating &lt; 12y and 33% gave birth to a first child &gt; 30y. Conclusions: This free, publicly accessible cancer risk assessment tool has a large user population with higher educational status, higher income, and smaller household than the general population. 97% of users report behaviors associated with cancer risk. Another 72% report non-modifiable risks. By understanding detailed characteristics of a large number of respondents, these data have the potential to answer many hypothesis-generating questions, with the ultimate goal of improving educational interventions to reduce cancer risk across the general public.

Association of Social and Behavioral Risk Factors With Earlier Onset of Adult Hypertension and Diabetes

The National Academy of Medicine has recommended incorporating information on social and behavioral factors associated with health, such as educational level and exercise, into electronic health records, but questions remain about the clinical value of doing so. To examine whether National Academy of Medicine-recommended social and behavioral risk factor domains are associated with earlier onset of hypertension and/or diabetes in a clinical population. This prospective cohort study used data collected from April 1, 2005, to December 31, 2016, from a population-based sample of 41 745 patients from 4 cycles of Kaiser Permanente Northern California's Adult Member Health Survey, administered to members at 19 Kaiser Permanente Northern California medical center service populations. The study used Kaplan-Meier survival tables and Cox proportional hazards regression analysis to estimate the onset of hypertension and diabetes among patients with no indication of disease at baseline. Data analysis was performed from June 2, 2017, to March 26, 2019. Race/ethnicity, educational level, financial worry, partnership status, stress, intimate partner violence, concentrated neighborhood poverty, depressive symptoms, infrequent exercise, smoking, heavy alcohol consumption, and cumulative social and behavioral risk. Onset of hypertension and diabetes during the 3.5 years after survey administration. The study included 18 133 people without baseline hypertension (mean [SD] age, 48.1 [15.3] years; 10 997 [60.7%] female; and 11 503 [63.4%] white) and 35 788 people without baseline diabetes (mean [SD] age, 56.2 [16.9] years; 20 191 [56.4%] female; and 24 351 [68.0%] white). There was a dose-response association between the number of social and behavioral risk factors and likelihood of onset of each condition. Controlling for age, sex, race/ethnicity, body mass index, and survey year, hazard ratios (HRs) comparing those with 3 or more risk factors with those with 0 risk factor were 1.41 (95% CI, 1.17-1.71) for developing hypertension and 1.53 (95% CI, 1.29-1.82) for developing diabetes. When the same covariates were adjusted for, having less than a high school educational level (hazard ratio [HR], 1.84; 95% CI, 1.40-2.43), being widowed (HR, 1.38; 95% CI, 1.11-1.71), concentrated neighborhood poverty (HR, 1.26; 95% CI, 1.00-1.59), infrequent exercise (HR, 1.22; 95% CI, 1.08-1.38), and smoking (HR, 1.35; 95% CI, 1.10-1.67) were significantly associated with hypertension onset. Having less than a high school educational level (HR, 1.58; 95% CI, 1.26-1.97), financial worry (HR, 1.29; 95% CI, 1.13-1.46), being single or separated (HR, 1.24; 95% CI, 1.08-1.42), high stress (HR, 1.28; 95% CI, 1.09-1.51), intimate partner violence (HR, 1.68; 95% CI, 1.14-2.48), concentrated neighborhood poverty (HR, 1.31; 95% CI, 1.07-1.60), depressive symptoms (HR, 1.28; 95% CI, 1.10-1.50), and smoking (HR, 1.53; 95% CI, 1.27-1.86) were significantly associated with diabetes onset, although heavy alcohol consumption was associated with protection (HR, 0.75; 95% CI, 0.66-0.85) rather than risk. Independent of traditional risk factors, individual and cumulative social and behavioral risk factor exposures were associated with onset of hypertension and diabetes within 3.5 years in a clinical setting. The findings support the value of assessing social and behavioral risk factors to help identify high-risk patients and of providing targets for intervention.

Prevalence of coronary artery disease and its relationship with various cardiovascular risk factors: Analysis of south Indian patients

AimsTo estimate the prevalence of coronary artery disease (CAD) and to understand the role of various risk factors and biochemical parameters among CAD patients in Singareni belt, south India. MethodsIn this cross-sectional screening study, all individuals aged >20 years of age who attended health check-up screening tests between May-2014 and May-2015 at Singareni Collieries Company, Telangana, India were examined for diagnosis of CAD and its risk factors. Accordingly, the prevalence of CAD among study participants was estimated. Further, various cardiovascular risk factors were compared between CAD and non-CAD individuals. ResultsA total of 440 subjects (age: 20–78 years; 65.9% males) were examined. CAD was diagnosed in 26 (5.9%) cases and treated at various centres in Telangana state. Comparison of CAD vs. non-CAD individuals revealed no significant difference for age, male proportion, body mass index, smoking habits, alcoholism, poor nutrition, infrequent exercise, psychological well-being, and social deprivation. Diabetes (46.2% vs. 32.6%) and hypertension (50.0% vs. 37.4%) were non-significantly higher among CAD individuals than in non-CAD individuals. Triglyceride levels were significantly higher (146.96±28.56 vs. 135.75±50.23; P=0.015), while very low density lipoprotein levels were significantly lower (25.27±11.33 vs. 26.98±15.59; P=0.030) among CAD individuals as compared to non-CAD individuals. Other lipid profile parameters, random blood sugar, haemoglobin, and serum creatinine levels were comparable between CAD and non-CAD individuals. ConclusionPrevalence of CAD was 5.9% in our study. We observed no significant differences between CAD and non-CAD individuals for various cardiovascular risk factors, lifestyle related factors, and majority of biochemical parameters.

Reduced CpG island methylation of the TBC1D8 gene may predict risk for osteoporosis in Chinese postmenopausal women.

Objective: In this study, we collected samples from postmenopausal women aged >60 y and evaluated bone mineral density (BMD) in addition to other biochemical variables to evaluate risk factors for osteoporosis. Furthermore, we investigated whether an association exists between the CpG island methylation levels in the promoter region of the TBC1D8 gene and osteoporosis incidence. Our goal was to identify contributing factors to the pathogenesis of osteoporosis and provide a theoretical basis for osteoporosis testing and therapy.Materials and Methods: We used questionnaires to collect data from Chinese Han women in their communities. The following parameters were measured: uric acid, high density lipoprotein, low density lipoprotein, fasting blood glucose, serum creatinine, serum calcium, serum phosphorus, alkaline phosphatase, P1NP, β-CTX, PTH, 25(OH)D and bone mineral density from lumbar spine 1 to 4, femoral neck, and total hip. DNA was also extracted to assess the methylation level of the TBC1D8 gene.Conclusions: Our findings suggest that a lower body mass index (BMI) infrequent exercise and certain sleep durations may be associated with osteoporosis. In addition, higher serum creatinine, β-CTX and PTH and lower 25(OH)D levels may be associated with osteoporosis. In Chinese Han postmenopausal women, decreased methylation of the TBCF1D8 gene promoter CpG islands is associated with osteoporosis. Finally, we also observed that TBC1D8 is negatively correlated with high density lipoprotein in postmenopausal women with osteoporosis.

Sex differences in sleep patterns and changes in 7th to 12th graders: a longitudinal follow-up study in Taiwan.

To assess the relationship between sex and the development of sleep patterns in adolescents from grade 7 to 12. We analyzed longitudinal data from annual school-based assessments of sleep habits among secondary school students in northern Taiwan. Measures of sleep patterns included sleep length on weekdays and weekends as well as weekend-weekday difference (WndD), defined as the discrepancy in the time in bed (TIB) between weekdays and weekends. Growth curve models were used to assess sex differences in sleep patterns. Associations between other covariates and sleep patterns were also explored. We found shorter weekday TIB in girls compared with boys at all time points. In contrast, girls had longer weekend TIB than boys over time except in the 12th grade. WndD was also longer in girls than boys. All interaction terms between sex and time were insignificant, indicating that developmental change across time was not statistically different for boys and girls. Several other factors, namely, parental education, pubertal development, self-perceived health, weight status, depressive symptoms, academic stress, infrequent exercise, and substance use, were also found to be associated with sleep patterns. Our findings show a sex difference in TIB both on weekdays and weekends. No sex difference was found in the development of sleep patterns over time.

Responses to intimate partners’ attempts to change health behavior

Intimate partners seeking to influence one another’s health may do so by providing support for positive health behavior and attempting to change negative health behavior (social control). Research findings examining the effectiveness of intimate partners’ attempts to influence health behavior are mixed however, and the purpose of the present research is to examine individuals’ responses to hypothetical health behavior influence attempts by an intimate partner. Specifically, we examine the role of readiness to change, cognitive appraisals, and affective responses to partner change attempts. Undergraduate students ( n = 185) who reported infrequent exercise or unhealthy eating habits were asked to respond to a variety of tactics an intimate partner might use to try to change their health behavior. In the first phase of the study, we examine a model wherein individuals’ readiness to change influences their perceptions of, and affective reactions to, attempts to influence health behavior and the subsequent likelihood of making a behavioral change. In Phase 2, we use a within-subjects experimental design to simulate changes in readiness and assess resulting changes to affective and perceptual responses to a variety of hypothetical support and control attempts by an intimate partner. The findings indicate that a comprehensive model that includes readiness to change more fully accounts for variance in how individuals respond to partners’ change attempts. Theoretical and clinical implications are discussed.

Burnout and health behaviors in health professionals from seven European countries.

Within an underlying health-impairing process, work stressors exhaust employees' mental and physical resources and lead to exhaustion/burnout and to health problems, with health-impairing behaviors being one of the potential mechanisms, linking burnout to ill health. The study aims to explore the associations between burnout and fast food consumption, exercise, alcohol consumption and painkiller use in a multinational sample of 2623 doctors, nurses and residents from Greece, Portugal, Bulgaria, Romania, Turkey, Croatia and Macedonia, adopting a cross-national approach. Data are part of the international cross-sectional quantitative ORCAB survey. The measures included the Maslach Burnout Inventory and the Health Behaviors Questionnaire. Burnout was significantly positively associated with higher fast food consumption, infrequent exercise, higher alcohol consumption and more frequent painkiller use in the full sample, and these associations remained significant after the inclusion of individual differences factors and country of residence. Cross-national comparisons showed significant differences in burnout and health behaviors, and some differences in the statistical significance and magnitude (but not the direction) of the associations between them. Health professionals from Turkey, Greece and Bulgaria reported the most unfavorable experiences. Burnout and risk health behaviors among health professionals are important both in the context of health professionals' health and well-being and as factors contributing to medical errors and inadequate patient safety. Organizational interventions should incorporate early identification of such behaviors together with programs promoting health and aimed at the reduction of burnout and work-related stress.