Examinando por Materia "Cardiovascular diseases"
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- PublicaciónAcceso abiertoAssociation of estimated sleep duration and naps with mortality and cardiovascular events(European Society of Cardiology, 2019-05-21) Wang, Chuangshi; Bangdiwala, Shrikant I.; Rangarajan, Sumathy; Lear, Scott A.; AlHabib, Khalid F.; Mohan, Viswanathan; Koon, Teo; Poirier, Paul; Tse, Lap Ah; Liu, Zhiguang; Rosengren, Annika; Kumar, Rajesh; Lopez-Jaramillo, Patricio; Yusoff, Khalid; Monsef, Nahed; Krishnapillai, Vijayakumar; Ismail, Noorhassim; Seron, Pamela; Dans, Antonio; Kruger, Lanthé; Yeates, Karen; Leach, Lloyd; Yusuf, Rita; Orlandini, Andres; Wolyniec, Maria; Bahonar, Ahmad; Mohan, Indu; Khatib, Rasha; Temizhan, Ahmet; Li, Wei; Yusuf, Salim; On behalf of the Prospective Urban Rural Epidemiology (PURE) study investigators; EverestAims To investigate the association of estimated total daily sleep duration and daytime nap duration with deaths and major cardiovascular events. Methods and results We estimated the durations of total daily sleep and daytime naps based on the amount of time in bed and self-reported napping time and examined the associations between them and the composite outcome of deaths and major cardiovascular events in 116 632 participants from seven regions. After a median follow-up of 7.8 years, we recorded 4381 deaths and 4365 major cardiovascular events. It showed both shorter (≤6 h/day) and longer (>8 h/day) estimated total sleep durations were associated with an increased risk of the composite outcome when adjusted for age and sex. After adjustment for demographic characteristics, lifestyle behaviours and health status, a J-shaped association was observed. Compared with sleeping 6–8 h/day, those who slept ≤6 h/day had a non-significant trend for increased risk of the composite outcome [hazard ratio (HR), 1.09; 95% confidence interval, 0.99–1.20]. As estimated sleep duration increased, we also noticed a significant trend for a greater risk of the composite outcome [HR of 1.05 (0.99–1.12), 1.17 (1.09–1.25), and 1.41 (1.30–1.53) for 8–9 h/day, 9–10 h/day, and >10 h/day, Ptrend < 0.0001, respectively]. The results were similar for each of all-cause mortality and major cardiovascular events. Daytime nap duration was associated with an increased risk of the composite events in those with over 6 h of nocturnal sleep duration, but not in shorter nocturnal sleepers (≤6 h). Conclusion Estimated total sleep duration of 6–8 h per day is associated with the lowest risk of deaths and major cardiovascular events. Daytime napping is associated with increased risks of major cardiovascular events and deaths in those with >6 h of nighttime sleep but not in those sleeping ≤6 h/night.
- PublicaciónAcceso abiertoCardiovascular Risk Factors in Colombian Penitentiary Staff: An Interdisciplinary View of a High-Risk Occupation(2021-09-26) Contreras-Ramos, Luz Mery; Domínguez-Amorocho, Omar Alberto; CliniUDESIntroduction: Cardiovascular risk factors have been measured under different conditions, there is some missing information related to specific occupations, such as penitentiary staff which due to their characteristics could have an increased cardiovascular risk. Objective: To determine cardiovascular risk factors on military staff from penitentiary institutions in Santander—Colombia. Methods: Cross-sectional study conducted with 182 workers. Anthropometric parameters, blood pressure, serum lipid profile, and glucose levels were measured. Univariate and bivariate analyses were carried out to establish differences between individuals. Results: Anthropometric and biochemical measures showed that 71.3% participants were overweight or obese, 29.4% presented high blood pressure with increased levels of total cholesterol (27.5%), triglycerides (40.7%), glucose (9.3%), and 84.1% presented low levels of HDL cholesterol. Bivariate analysis found a negative correlation between BMI and HDL cholesterol (p < .05) and a positive correlation between BMI with triglycerides (p < .01), systolic and diastolic blood pressure (DBP) (p < .01). Conclusion: The studied military population presented increased levels of cardiovascular risk in comparison with a similar group in age, gender of nonmilitary individuals. However, it is important to carry out comparative studies between military staff in order to determine the prevalence and other risk predicting factors present in this specific population.
- PublicaciónAcceso abiertoCostos directos e indirectos derivados del cuidado familiar del paciente con enfermedad crónica no transmisible(Universidad de la Sabana, 2020-06-30) Páez Esteban, Astrid-Nathalia; Torres Contreras, Claudia-Consuelo; Campos de Aldana, María-Stella; Solano Aguilar, Sonia; Quintero Lozano, Nubia; Chaparro Díaz, Olivia Lorena; EverestObjetivo: determinar los costos directos no aplicables a los servicios de salud e indirectos derivados del cuidado familiar del paciente con enfermedad crónica no transmisible (ECNT) de tres instituciones de salud del área metropolitana de Bucaramanga, Colombia. Metodología: estudio transversal descriptivo en 77 personas con ECNT y sus cuidadores familiares, seleccionados mediante muestreo sistemático entre 2018 y 2019. Resultados: la mayoría de las personas con ECNT son mujeres (55 %), con una edad media de 70 años. Cuatro de cada cinco cuidadores son mujeres, con una edad media de 40 años, y ofrecen cuidados 14 horas por día, en promedio. El costo total mensual atribuido al cuidado familiar del paciente fue de 324.207 pesos colombianos, en promedio. Los costos más representativos son en salud, alimentación, vivienda, transporte y comunicaciones. El 60,5 % de los pacientes con ECNT asumían las finanzas del hogar antes de enfermar y, de estos, aproximadamente la mitad dejó de trabajar y la otra mitad presentó una reducción del 33 % en sus ingresos mensuales después de enfermar. Conclusión: los costos relacionados con el cuidado familiar aumentan y los ingresos de los pacientes con ECNT y de sus cuidadores disminuyen, debido a que se requieren tratamientos, cuidados e intervenciones complementarias e integrales, entre otras.
- PublicaciónAcceso abiertoDefining the research priorities to fight the burden of cardiovascular diseases in Latin America(2008-05) Lopez-Jaramillo, Patricio
- PublicaciónRestringidoMaternal undernutrition and cardiometabolic disease : A Latin American perspective(2015-03-02) Lopez-Jaramillo, Patricio; Gómez Arbeláez, Diego; Sotomayor Rubio, Aristides; Mantilla Garcia, Daniel; López López, JoseThe current epidemic of obesity and cardiometabolic diseases in developing countries is described as being driven by socioeconomic inequalities. These populations have a greater vulnerability to cardiometabolic diseases due to the discrepancy between the maternal undernutrition and its consequence, low-birth weight progeny, and the subsequent modern lifestyles which are associated with socioeconomic and environmental changes that modify dietary habits, discourage physical activity and encourage sedentary behaviors. Maternal undernutrition can generate epigenetic modifications, with potential long-term consequences. Throughout life, people are faced with the challenge of adapting to changes in their environment, such as excessive intake of high energy density foods and sedentary behavior. However, a mismatch between conditions experienced during fetal programming and current environmental conditions will make adaptation difficult for them, and will increase their susceptibility to obesity and cardiovascular diseases. It is important to conduct research in the Latin American context, in order to define the best strategies to prevent the epidemic of cardiometabolic diseases in the region.
- PublicaciónRestringidoReevaluating nutrition as a risk factor for cardio-metabolic diseases(2018-04) Lopez-Jaramillo, Patricio; Otero, Johanna; Camacho López, Paul Anthony; Baldeón, Manuel; Fornasini, MarcoIntroduction: The consumption of saturated fats is considered a risk factor for cardiovascular diseases. Objective: Review published papers on the role of macro-nutrient intake in cardiovascular risk. Results: Recent reports from the PURE study and several previous meta-analyses, show that the consumption of total saturated and unsaturated fat is not associated with risk of acute myocardial infarction or mortality due to cardiovascular disease. High carbohydrate intake was associated with the highest risk of total and cardiovascular mortality, while total fat consumption or of its different types was associated with a lower risk of mortality. A high consumption of fruits, vegetables and legumes was associated with lower risk of total mortality and non-cardiovascular mortality. The consumption of 100 g of legumes, two or three times a week, ameliorated deficiencies of the nutrients contained in these foods and was associated with a reduction in the risk of developing chronic non-communicable diseases. Conclusion: A healthy diet should be balanced and varied, be composed of a proportion of complex carbohydrates rich in fibber between 50-55% of the daily energy consumed, of saturated and unsaturated fat (25-30%), animal and vegetable protein (including legumes) between 15-25%, vitamins, minerals and water. These nutrients are abundantly present in fruits, vegetables, cereals, legumes, milk and its derivatives, eggs and meats, so public policies should promote the availability and access to these nutrients within primary prevention programs to reduce the growing prevalence of cardio-metabolic diseases.
- PublicaciónAcceso abiertoReliability of the scale of barriers for cardiac rehabilitation in the colombian population(2021-04-20) Jácome-Hortúa, Adriana Marcela; Angarita-Fonseca, Adriana; Villamizar Jaimes, Carmen Juliana; Martínez-Marín, Rocio del Pilar; Dutra de Souza, Hugo Celso; Facioli, Tábata de Paula; Sánchez-Delgado, Juan Carlos; Fisioterapia IntegralCardiac rehabilitation is supported by the highest level of scientific evidence. However, less than 25% of those eligible to participate in a cardiac rehabilitation program initiate it; and of these, 50% drop out prematurely. A modified Spanish Cardiac Rehabilitation Barriers Scale (CRBS) has been translated, culturally adapted and validated in Colombia, however, the reliability remains to be evaluated. This study aimed to determine the internal consistency and test–retest reliability of the CRBS in a Colombian population. In total, 193 patients (67% men, average age = 65 ± 12 years) completed the scale twice, with an average of eight days between applications. Cronbach’s Alpha and intraclass correlation coefficients (ICC) were calculated. The internal consistency of the Colombian version of the CRBS was acceptable (Cronbach’s alpha = 0.84). The ICC of the CRBS was 0.69 (95% CI 0.61–0.76); 0.78 (95% CI 0.71–0.84) when the CRBS was completed by interview; and 0.47 (95% CI 0.21–0.67) when the CRBS was self-reported. The reliability of the interview version of the CRBS was substantial in the Colombian population; however, the reliability of the self-report version was lower. The use of this scale will allow developing strategies to increase participation and adherence to cardiac rehabilitation programs.
- PublicaciónAcceso abiertoSodium intake recommendations : A subject that needs to be reconsidered(2015-04) Lopez-Jaramillo, Patricio; López López, Jose; López López, CristinaHypertension affects 1 billion people worldwide and is considered the leading cause of death, stroke, myocardial infarction and congestive heart failure. Sodium intake is reported to be a modifiable determinant of hypertension and reductions in its consumption have been widely recommended. Various strategies have been proposed to address the observed epidemic of cardiovascular diseases, particularly in medium and low-income countries. Among these strategies, reducing dietary sodium intake and increasing dietary potassium intake are commonly included in guidelines for the treatment of hypertension and the prevention of cardiovascular disease. In the present article, we review the results of recent studies that have raised questions about potential adverse effects associated with low sodium intake on important health outcomes, including cardiovascular diseases and death. It is clear from these studies, that there are contradictory and irreconcilable positions in the interpretation of the evidence, a situation that indicates that there is an urgent need for international randomized controlled trials that consistently demonstrate that the low levels of sodium intake recommended in the guidelines are safe and beneficial for different populations around the world. In the interim, and in accordance with a number of experts, we agree that the current evidence argues against the reduction of dietary sodium as an isolated public health recommendation and that an alternative approach of recommending high quality, potassium rich diets, might achieve greater health benefits, including blood-pressure reduction, than aggressive sodium reduction alone.
- PublicaciónAcceso abiertoThe effects of maintenance cardiac rehabilitation: A systematic review and Meta-analysis, with a focus on sex(2021-07-06) Chowdhury, Mohiul; Heald, Fiorella A.; Sanchez-Delgado, Juan C.; Pakosh, Mauree; Jacome-Hortua, Adriana M.; Grace, Sherry L.; Fisioterapia IntegralPhase III/IV cardiac rehabilitation (CR) is recommended to promote maintenance of benefits achieved during Phase II; there has been no meta-analysis to test this to date. This study determined the effects of maintenance CR on any outcome, with consideration of sex. Seven databases were searched from inception-January 2020. Randomized controlled trials on the effects of maintenance CR in cardiovascular disease patients who had graduated from CR were included. Level of evidence was evaluated with GRADEPro. 819 citations were identified, with 10 trials (21 papers) included (5238 participants; 859 [16.4%] female). Maintenance CR resulted in lower low-density lipoprotein (mean difference [MD]=-0.58; 95% confidence interval [CI]=-1.06–-0.10, n = 392) and greater quality of life (MD = 0.28, 95% CI = 0.05–0.52, n = 118) when compared to usual care only. Outcomes for women and sex differences were mixed. In conclusion, maintenance programs appear to sustain patient's quality of life, but more focus on women's outcomes is needed.
- PublicaciónAcceso abiertoValidez de contenido de la escala de barreras para la rehabilitación cardíaca(2015-09) Sánchez Delgado, Juan Carlos; Jácome Hortúa, Adriana; Pinzón, Sandra; Angarita Fonseca, AdrianaIntroducción: La ausencia de instrumentos con adecuadas propiedades psicométricas adaptados para Colombia, que evalúen las barreras de acceso a los programas de rehabilitación cardiovascular justifica esta investigación. Objetivo: Determinar la validez de contenido de la Escala de Barreras para la Rehabilitación Cardiaca en población colombiana. Métodos y materiales: Se realizó un estudio de pruebas diagnósticas. En la primera fase se requiririeron dos traductores de lengua materna español y uno de lengua materna inglesa para la traducción y retrotraducción del cuestionario original. En la segunda fase se realizó la adaptación transcultural y se evaluó la validez de contenido mediante un panel de cuatro expertos con experiencia en investigación, medicina deportiva y rehabilitación cardiaca. Resultados: El instrumento fue traducido y adaptado al español colombiano. El panel de expertos decidió eliminar el ítem 18 de la escala original. El índice de validez de contenido fue aceptable para la mayoría de los ítems, excepto para los ítems 10, 15 y 18, por lo cual se realizaron modificaciones en palabras, frases o conjugaciones verbales según las recomendaciones del panel. Por otra parte, el Indice de Validez de Contenido en relevancia fue de 0,86 y en pertinencia de 0,88. Conclusión: Se cuenta con un instrumento que evalúa barreras de acceso a los programas de rehabilitación cardiovascular adaptada a población colombiana y con validez de contenido, por lo cual los resultados que se obtengan de la aplicación de la escala serán válidos. No obstante, se sugiere continuar con la evaluación de la reproducibilidad del instrumento.