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- 16 September 2018
Showing posts with label risk factors. Show all posts
Showing posts with label risk factors. Show all posts
Sunday, July 28, 2019
Wednesday, November 21, 2018
SE Deprivation Health Outcomes
The effect of socioeconomic deprivation on the associationbetween an extended measurement of unhealthy lifestylefactors and health outcomes: a prospective analysis of theUK Biobank cohort
Hamish M E Foster*, Carlos A Celis-Morales*, Barbara I Nicholl, Fanny Petermann-Rocha, Jill P Pell, Jason M R Gill†, Catherine A O’Donnell†, Frances S Mair†
Summary
Background Combinations of lifestyle factors interact to increase mortality. Combinations of traditional factors such as smoking and alcohol are well described, but the additional effects of emerging factors such as television viewing time are not. The effect of socioeconomic deprivation on these extended lifestyle risks also remains unclear. We aimed to examine whether deprivation modifies the association between an extended score of lifestyle-related risk factors and health outcomes. Methods Data for this prospective analysis were sourced from the UK Biobank, a prospective population-based cohort study. We assigned all participants an extended lifestyle score, with 1 point for each unhealthy lifestyle factor (incorporating sleep duration and high television viewing time, in addition to smoking, excessive alcohol, poor diet [low intake of oily fish or fruits and vegetables, and high intake of red meat or processed meats], and low physical activity), categorised as most healthy (score 0–2), moderately healthy (score 3–5), or least healthy (score 6–9). Cox proportional hazards models were used to examine the association between lifestyle score and health outcomes (all-cause mortality and cardiovascular disease mortality and incidence), and whether this association was modified by deprivation. All analyses were landmark analyses, in which participants were excluded if they had an event (death or cardiovascular disease event) within 2 years of recruitment. Participants with non-communicable diseases (except hypertension) and missing covariate data were excluded from analyses. Participants were also excluded if they reported implausible values for physical activity, sleep duration, and total screen time. All analyses were adjusted for age, sex, ethnicity, month of assessment, history of hypertension, systolic blood pressure, medication for hypercholesterolaemia or hypertension, and body-mass index categories/.../
Hamish M E Foster*, Carlos A Celis-Morales*, Barbara I Nicholl, Fanny Petermann-Rocha, Jill P Pell, Jason M R Gill†, Catherine A O’Donnell†, Frances S Mair†
Summary
Background Combinations of lifestyle factors interact to increase mortality. Combinations of traditional factors such as smoking and alcohol are well described, but the additional effects of emerging factors such as television viewing time are not. The effect of socioeconomic deprivation on these extended lifestyle risks also remains unclear. We aimed to examine whether deprivation modifies the association between an extended score of lifestyle-related risk factors and health outcomes. Methods Data for this prospective analysis were sourced from the UK Biobank, a prospective population-based cohort study. We assigned all participants an extended lifestyle score, with 1 point for each unhealthy lifestyle factor (incorporating sleep duration and high television viewing time, in addition to smoking, excessive alcohol, poor diet [low intake of oily fish or fruits and vegetables, and high intake of red meat or processed meats], and low physical activity), categorised as most healthy (score 0–2), moderately healthy (score 3–5), or least healthy (score 6–9). Cox proportional hazards models were used to examine the association between lifestyle score and health outcomes (all-cause mortality and cardiovascular disease mortality and incidence), and whether this association was modified by deprivation. All analyses were landmark analyses, in which participants were excluded if they had an event (death or cardiovascular disease event) within 2 years of recruitment. Participants with non-communicable diseases (except hypertension) and missing covariate data were excluded from analyses. Participants were also excluded if they reported implausible values for physical activity, sleep duration, and total screen time. All analyses were adjusted for age, sex, ethnicity, month of assessment, history of hypertension, systolic blood pressure, medication for hypercholesterolaemia or hypertension, and body-mass index categories/.../
Monday, September 17, 2018
Aspirin-a-day...
Recomendado pelo AMICOR Moacyr Saffer
'Aspirin-a-day risky in old age' - major study
GETTY IMAGES
Elderly people in good health should not take an aspirin a day, according to a major study in the US and Australia.
There are proven benefits of the drug for people after a heart attack or stroke.
But the trial found no benefit for healthy people over the age of 70, and the pills increased the risk of potentially fatal internal bleeding.
https://www.medpagetoday.com/cardiology/prevention/75123?xid=nl_mpt_DHE_2018-09-17&eun=g490339d0r&pos=&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-09-17&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20daysThursday, October 20, 2016
Physical Activity and Chronic Diseases
Physical Activity Prescription: A Critical Opportunity to Address a Modifiable Risk Factor for the Prevention and Management of Chronic Disease
A Position Statement by the Canadian Academy of Sport and Exercise Medicine
Br J Sports Med. 2016;50(18):1109-1114.
Abstract and Introduction
Abstract
Non-communicable disease is a leading threat to global health. Physical inactivity is a large contributor to this problem; in fact, the WHO ranks it as the fourth leading risk factor for overall morbidity and mortality worldwide. In Canada, at least 4 of 5 adults do not meet the Canadian Physical Activity Guidelines of 150 min of moderate-to-vigorous physical activity per week. Physicians play an important role in the dissemination of physical activity (PA) recommendations to a broad segment of the population, as over 80% of Canadians visit their doctors every year and prefer to get health information directly from them. Unfortunately, most physicians do not regularly assess or prescribe PA as part of routine care, and even when discussed, few provide specific recommendations. PA prescription has the potential to be an important therapeutic agent for all ages in primary, secondary and tertiary prevention of chronic disease. Sport and exercise medicine (SEM) physicians are particularly well suited for this role and should collaborate with their primary care colleagues for optimal patient care. The purpose of this Canadian Academy and Sport and Exercise Medicine position statement is to provide an evidence-based, best practices summary to better equip SEM and primary care physicians to prescribe PA and exercise, specifically for the prevention and management of non-communicable disease. This will be achieved by addressing common questions and perceived barriers in the field./.../
Friday, July 22, 2016
Saturday, January 03, 2015
Aleatoriedade de Risco
http://www.theguardian.com/science/grrlscientist/2015/jan/02/bad-luck-bad-journalism-and-cancer-rates
These data suggest there is a relationship between risk of cancer and number of cell divisions. But it says nothing about the proportion of cancers due to cell division.
Saturday, August 16, 2014
About Risk and Personality
What Children Can Teach Us About Risk, Failure, and Personal Growth
by Maria Popova
“Our fear of failure … assures the progressive narrowing of the personality.”
“If I limit myself to knowledge that I consider true beyond doubt,” E.F. Schumacher wrote in his timelessly wonderful A Guide for the Perplexed in 1977, “I minimize the risk of error but I maximize, at the same time, the risk of missing out on what may be the subtlest, most important and most rewarding things in life.” In the decades since, the notion of embracing risk and failure has become one of the most common tropes in motivational talks, self-help books and business articles alike. It’s been championed by everyone from Ray Bradbury, who considered failure essential to creativity, to Pixar co-founder Ed Catmull, who argued for the importance of cultivating a failure-fearless culture, but none more eloquently than social science writer John W. Gardner in a section of Self-Renewal: The Individual and the Innovative Society(public library) — his altogether fantastic, forgotten field guide to keeping your company and your soul vibrantly alive, which remains a must-read as much for entrepreneurs as for those of us on a private journey of self-transcendence./.../Thursday, July 17, 2014
Alcohol and CVD
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Thursday, May 01, 2014
Measuring risk with excercise
DRUG & REFERENCE INFORMATION
Three measures of physical capability in middle age could predict subsequent mortality risk, and light activity reduces disability, according to 2 studies published online April 29 in theBMJ.
The first study, by Rachel Cooper, PhD, from the Medical Research Council Unit for Lifelong Health and Ageing at University College London, United Kingdom, and colleagues looked at 3 measures of physical capability (grip strength, chair rise time, and standing balance time) and their association with all-cause mortality from 1999 to 2012 in a prospective cohort study. The team also tested a composite measure of the 3 tasks for association with mortality./.../
VIGITEL: Fumo e Sobrepeso
Ranking indigesto
Porto Alegre é a capital com mais fumantes e a segunda em sobrepeso
Dados foram divulgados nesta quarta-feira em pesquisa do Ministério da Saúde
por Débora Ely
Porto-alegrenses: somos mais de 794 mil gordos e 242 mil fumantes. Os números — incluÃdos na pesquisa Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) — foram divulgados na manhã de quarta-feira pelo Ministério da Saúde. Mesmo com a queda no percentual de pessoas que fumam (atualmente a população de fumantes na cidade é de 16,5%, mas, em 2012, era de 18,2%), ainda não há motivo para comemorar. A capital gaúcha segue liderando o ranking nacional de consumo de cigarros.
Para o coordenador da Comissão de Tabagismo da Sociedade Brasileira de Pneumologia, Luiz Carlos Corrêa da Silva, a colocação de Porto Alegre não chega a ser uma surpresa. Afinal, tradicionalmente, o municÃpio aparece entre os primeiros colocados na amarga lista.
— Não se trata apenas de Porto Alegre, mas de todos o Estado. Nossa origem étnica, bem misturada com a europeia, pode influenciar a predisposição, apesar de poder não ser o principal fator. Existem questões genéticas que influenciam na maior ou menor facilidade da pessoa ficar dependente. Outra questão diz respeito à região do paÃs que mais produz tabaco, que é o Sul. Isso tem um significado importante, também — avalia Silva.
Já os resultados nacionais agradaram ao Ministério da Saúde. Desde 2006 — primeiro ano de realização da pesquisa — a parcela da população do paÃs que fuma caiu 28%. Hoje, 11,3% dos brasileiros se declaram fumantes.
Para o coordenador da Comissão de Tabagismo da Sociedade Brasileira de Pneumologia, Luiz Carlos Corrêa da Silva, a colocação de Porto Alegre não chega a ser uma surpresa. Afinal, tradicionalmente, o municÃpio aparece entre os primeiros colocados na amarga lista.
— Não se trata apenas de Porto Alegre, mas de todos o Estado. Nossa origem étnica, bem misturada com a europeia, pode influenciar a predisposição, apesar de poder não ser o principal fator. Existem questões genéticas que influenciam na maior ou menor facilidade da pessoa ficar dependente. Outra questão diz respeito à região do paÃs que mais produz tabaco, que é o Sul. Isso tem um significado importante, também — avalia Silva.
Já os resultados nacionais agradaram ao Ministério da Saúde. Desde 2006 — primeiro ano de realização da pesquisa — a parcela da população do paÃs que fuma caiu 28%. Hoje, 11,3% dos brasileiros se declaram fumantes.
A segunda cidade com mais gordos do paÃs
De cada dois porto-alegrenses, um — ao subir na balança — vê o ponteiro avançar mais do que deveria. Na Capital, 54,1% dos moradores estão com sobrepeso, apontou a pesquisa. O indigesto valor, o mesmo verificado no estudo anterior, deixa a cidade na segunda colocação no ranking nacional, ficando atrás apenas de Cuiabá e bem à frente da vizinha Florianópolis, que ocupa a 21ª posição. E são os homens os responsáveis por manter a Capital no topo da lista dos mais cheinhos do Brasil: 62,1% deles estão gordos, contra 47,5% das mulheres.
Historicamente, Porto Alegre apresenta os mais altos percentuais de pessoas fora do peso ideal no paÃs. Em 2006 éramos uma população com 48,9% de gordos, enquanto a média nacional era de 42,6%. Hoje, ainda estamos mais pesados do que o resto do paÃs — cuja média atual é de 50,8%.
Mas, afinal, o que explica o comportamento do porto-alegrense que insiste em negligenciar hábitos saudáveis? A culpa — ou, pelo menos, parte dela — é da costela, da cuca e da macarronada.
— Porto Alegre é uma cidade gaúcha, com hábitos locais diferentes de outros Estados. As populações que colonizaram a cidade, em grande parte, foram as alemãs e italian a s. Além disso, temos os hábitos tradicionalmente gaúchos, como o churrasco. Mas esse é um cenário populacional inteiro. A comida ficou mais barata e mais gorda — aponta o diretor do Centro da Obesidade do Hospital São Lucas da PUCRS, Claudio Corá Mottin.
O secretário de Vigilância em Saúde do ministério, Jarbas Barbosa, aponta justamente as caracterÃsticas regionais para explicar a variação de percentuais:
— Esse Ãndice pode ser alterado pela própria estrutura demográfica das cidades. Como o excesso de peso tende a aumentar ao longo da vida, capitais que têm um processo de envelhecimento mais acentuado pode m apresentar essa diferença no comportamento.
No quesito obesidade, Porto Alegre aparece na 12ª posição, com percentual de 17,7% — bem próximo à média nacional, de 17,5%. O dado verificado em todo o Brasil também agradou ao Ministério da Saúde, já que, pela primeira vez desde 2006 — ano da primeira pesquisa Vigitel —, a obesidade parou de crescer no paÃs. O estudo que retrata os hábitos da população brasileira é feito anualmente e, nesta edição, ouviu 53 mil adultos em todas as 26 capitais e também no Distrito Federal.
Monday, October 07, 2013
Framingham 65
Framingham Heart Study Celebrates 65 Years
Oct 03, 2013
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DRUG & REFERENCE INFORMATION
FRAMINGHAM, MA — The Framingham Heart Study (FHS), the longest-running study of cardiovascular disease and its risk factors, is turning 65 years old next week. The study, which had its start closely linked with the cardiovascular health of USPresident Franklin Delano Roosevelt, examined its first patient on October 11, 1948.
Dr Thomas Wang (Vanderbilt University Medical Center, Nashville, TN), an FHS associate when he was at Massachusetts General Hospital for the past decade, along with Dr Syed Mahmood (Harvard Medical School, Boston MA) and Drs Daniel Levy and Ramachandran Vasan (Boston University School of Medicine, MA) highlight the history of the FHS in a new review published online September 29, 2013 in the Lancet [1].
Speaking with heartwire , Wang said it would be difficult to highlight just a single contribution the FHS has made to the cardiovascular community, but the concept of the cardiovascular disease risk factor and later formalizing these risk factors into the Framingham Risk Score is a contribution that will endure. In addition, the study helped physicians understand the role hypertension plays in the development of numerous diseases, such as heart failure, MI, and stroke.
"Framingham has certainly also contributed to our understanding of blood pressures that we used to tolerate as within the 'normal range' and are, in fact, associated with an elevated risk of heart disease," said Wang. "It refocused our attention on people with lesser degrees of blood-pressure elevation. I think this has been one of the real values of the epidemiologic observations from Framingham."
President Roosevelt's Failing Health
The study was planned by the US Public Health Service in 1947, with Framingham, MA, selected as the study site. With the passing of the 1948 National Heart Act by President Harry Truman, $500 000 was set aside for the FHS and the first patient examined shortly thereafter.
Truman had been the vice president to Roosevelt and watched as the president was diagnosed with hypertension and heart failure in 1944. Roosevelt died of a stroke on April 12, 1945 and was reported to have a blood pressure of 300/190 mm Hg at the time of his cerebral hemorrhage. In 1932, his campaign released medical records showing that FDR had a blood pressure of 180/100 mm Hg, which his physician said was normal for a man his age.
"In some ways, focusing on an American president is convenient, because I don't think anyone would question that he would get what would be considered the best medical care at the time," said Wang. "It shows that back then much higher blood pressures were considered a natural fact of aging, when in fact there is nothing natural about it."
Budget Cuts and an Uncertain Future
The 65th anniversary of the FHS comes during an uncertain time. As reported by heartwire , the FHS will have its funding cut by 40%. The reason for the cutbacks is the automatic funding cuts that went into place as a result of the US government sequestration. The study is still continuing, but layoffs are expected later this year, including 19 administrative and clinical positions.
The FHS Offspring and Omni Group 1 exams scheduled for this year are still ongoing and ancillary studies are continuing as planned, and all medical-history updates are being collected as part of the schedule. However, the current cycle of FHS examinations will finish up in the fall of 2013, and no additional examinations of the participants are planned for the contract period. The current contract period expires March 31, 2015.
The FHS receives approximately $9 million from the US government through its contract with the National Heart, Lung, and Blood Institute (NHLBI). The funding is to be reduced by $4 million in upcoming years, a 40% reduction.
"The magnitude of cuts is clearly going to have an impact," said Wang. "One of the things that might happen is that the routine follow-up examinations that have been going on for 65 years may stop, and that will clearly change the nature of the study. Much of the study has been based on the personal interactions the investigators have had with the volunteers in the Framingham community."
Still, Wang said he is not disparaging the cutbacks, saying the National Institutes of Health (NIH) is simply trying to deal with the reality of the sequester. The Lancet review of the historic study was not intended as a swipe to the NIH, stressed Wang, telling heartwire they published the account to let other physicians and researchers know about the historic study's origins. The 65th anniversary simply coincided with the 2013 sequester and subsequent budget cuts.
The NIH had its 2013 fiscal year budget cut by $1.55 billion cut as a result of the sequester, and all institutes at the NIH were required to apply the cut across all programs, projects, and activities. Wang told heartwire the FHS investigators are continuing to look for other ways of funding the follow-up exams outside the NIH contract.
The authors report no conflicts of interest.
Monday, September 30, 2013
Early Life Holds Clues to Adult Heart Health
Published: Sep 30, 2013
Family socioeconomic status, body mass index, and either personal or parental smoking during childhood predicted the likelihood of achieving ideal cardiovascular health as an adult, researchers found.
Better socioeconomic status and lower BMI were significantly associated with having ideal cardiovascular health 2 to 3 decades later in three cohort studies conducted in Finland, Australia, and the U.S. (P<0 .01="" according="" and="" bm="" both="" colleagues.="" finland="" for="" in="" laitinen="" of="" p="" the="" to="" tomi="" turku="" university="" variables="">
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