Examinando por Materia "Primary prevention"

Mostrando 1 - 5 de 5
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    Antihypertensives and Statin Therapy for Primary Stroke Prevention: A Secondary Analysis of the HOPE-3 Tria
    (Stroke, 2021-05-14) Bosch, Jackie; Lonn, Eva; Dagenais, Gilles; Gao, Peggy; Lopez-Jaramillo, Patricio; Zhu, Jun; Pais, Prem; Avezum, Alvaro; Sliwa, Karen; Chazova, Irina E.; Peters, Ron; Held, Claes; Yusoff, Khalid; Lewis, Basil S.; Toff, William D.; Khunti, Kamlesh; Reid, Christopher M.; Leiter, Lawrence A.; Yusuf, Salim; Hart, Robert G.; The HOPE-3 Investigators; Masira
    Background and Purpose: The HOPE-3 trial (Heart Outcomes Prevention Evaluation–3) found that antihypertensive therapy combined with a statin reduced first stroke among people at intermediate cardiovascular risk. We report secondary analyses of stroke outcomes by stroke subtype, predictors, treatment effects in key subgroups. Methods: Using a 2-by-2 factorial design, 12 705 participants from 21 countries with vascular risk factors but without overt cardiovascular disease were randomized to candesartan 16 mg plus hydrochlorothiazide 12.5 mg daily or placebo and to rosuvastatin 10 mg daily or placebo. The effect of the interventions on stroke subtypes was assessed. Results: Participants were 66 years old and 46% were women. Baseline blood pressure (138/82 mm Hg) was reduced by 6.0/3.0 mm Hg and LDL-C (low-density lipoprotein cholesterol; 3.3 mmol/L) was reduced by 0.90 mmol/L on active treatment. During 5.6 years of follow-up, 169 strokes occurred (117 ischemic, 29 hemorrhagic, 23 undetermined). Blood pressure lowering did not significantly reduce stroke (hazard ratio [HR], 0.80 [95% CI, 0.59–1.08]), ischemic stroke (HR, 0.80 [95% CI, 0.55–1.15]), hemorrhagic stroke (HR, 0.71 [95% CI, 0.34–1.48]), or strokes of undetermined origin (HR, 0.92 [95% CI, 0.41–2.08]). Rosuvastatin significantly reduced strokes (HR, 0.70 [95% CI, 0.52–0.95]), with reductions mainly in ischemic stroke (HR, 0.53 [95% CI, 0.37–0.78]) but did not significantly affect hemorrhagic (HR, 1.22 [95% CI, 0.59–2.54]) or strokes of undetermined origin (HR, 1.29 [95% CI, 0.57–2.95]). The combination of both interventions compared with double placebo substantially and significantly reduced strokes (HR, 0.56 [95% CI, 0.36–0.87]) and ischemic strokes (HR, 0.41 [95% CI, 0.23–0.72]). Conclusions: Among people at intermediate cardiovascular risk but without overt cardiovascular disease, rosuvastatin 10 mg daily significantly reduced first stroke. Blood pressure lowering combined with rosuvastatin reduced ischemic stroke by 59%. Both therapies are safe and generally well tolerated.
  • Publicación
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    Factores de riesgo asociados a desordenes musculo esqueléticos en una empresa de fabricación de refrigeradores
    (2018) Castro Castro, Gisella-Catherine; Ardila Pereira, Laura-Cecilia; Orozco Muñoz, Yaneth del Socorro; Sepúlveda Lazaro, Eliana E.; Molina Castro, Carmen E.
    Objetivo Establecer los factores de riesgo asociados a desordenes musculo esqueléticos en trabajadores operativos de una empresa de fabricación de refrigeradores en Barranquilla, Colombia. Materiales y Métodos Investigación de tipo transversal descriptivo. Se realizó un muestreo por conveniencia, constituida por 79 trabajadores. Los instrumentos utilizados fueron: PAR-Q ((cuestionario de aptitud para la actividad física), IMC (índice de Masa Corporal), cuestionario nórdico y método REBA. Resultados Del total de la población encuestada, se determinó que el 60,8% refirió alguna sintomatología osteomuscular; el 48,1% manifestó tener afectado un solo segmento corporal, el 10,1% con 2 segmentos y con 3 o 4 segmentos comprometidos un 1,3% respectivamente. El segmento corporal con mayor afectación fue el dorsolumbar relacionado con cargos como operario de armado, operario de enchape, de inyección y soldador. Conclusión El colectivo de trabajadores de las áreas de armado, enchape, inyección y soldadura está especialmente expuesto a factores de riesgo que aumentan la probabilidad de padecer molestias y daños musculoesqueléticos. Los movimientos repetitivos de extremidades superiores y la manipulación manual de cargas destacan entre los riesgos ergonómicos y las exigencias de atención, los altos ritmos de trabajo y los plazos cortos entre los riesgos psicosociales a los que está expuesto este colectivo. Además, que el índice de masa corporal es un factor importante ante la aparición de desórdenes musculo esqueléticos.
  • Publicación
    Acceso abierto
    Lowering cholesterol, blood pressure, or both to prevent cardiovascular events: Results of 8.7 years of follow-up of Heart Outcomes Evaluation Prevention (HOPE)-3 study participants
    (Oxford Academic, 2021-08-14) Bosch, Jackie; Lonn, Eva M.; Jung, Hyejung; Zhu, Jun; Liu, Lisheng; Lopez-Jaramillo, Patricio; Pais, Prem; Xavier, Denis; Diaz, Rafael; Dagenais, Gilles; Dans, Antonio; Avezum, Alvaro; Piegas, Leopoldo S.; Parkhomenko, Alexander; Keltai, Kati; Keltai, Matya; Sliwa, Karen; Held, Claus; Peters, Ronald J.G.; Lewis, Basil S.; Jansky, Petr; Yusoff, Khalid; Khunti, Kamlesh; Toff, William D.; Reid, Christopher M.; Varigos, John; Joseph, Philip; Leiter, Lawrence A.; Yusuf, Salim; The Heart Outcomes Prevention Evaluation (HOPE)-3 Investigators; Masira
    Aims. Rosuvastatin (10 mg per day) compared with placebo reduced major adverse cardiovascular (CV) events by 24% in 12 705 participants at intermediate CV risk after 5.6 years. There was no benefit of blood pressure (BP) lowering treatment in the overall group, but a reduction in events in the third of participants with elevated systolic BP. After cessation of all the trial medications, we examined whether the benefits observed during the active treatment phase were sustained, enhanced, or attenuated. Methods and results. After the randomized treatment period (5.6 years), participants were invited to participate in 3.1 further years of observation (total 8.7 years). The first co-primary outcome for the entire length of follow-up was the composite of myocardial infarction, stroke, or CV death [major adverse cardiovascular event (MACE)-1], and the second was MACE-1 plus resuscitated cardiac arrest, heart failure, or coronary revascularization (MACE-2). In total, 9326 (78%) of 11 994 surviving Heart Outcomes Prevention Evaluation (HOPE)-3 subjects consented to participate in extended follow-up. During 3.1 years of post-trial observation (total follow-up of 8.7 years), participants originally randomized to rosuvastatin compared with placebo had a 20% additional reduction in MACE-1 [95% confidence interval (CI), 0.64–0.99] and a 17% additional reduction in MACE-2 (95% CI 0.68–1.01). Therefore, over the 8.7 years of follow-up, there was a 21% reduction in MACE-1 (95% CI 0.69–0.90, P = 0.005) and 21% reduction in MACE-2 (95% CI 0.69–0.89, P = 0.002). There was no benefit of BP lowering in the overall study either during the active or post-trial observation period, however, a 24% reduction in MACE-1 was observed over 8.7 years. Conclusion. The CV benefits of rosuvastatin, and BP lowering in those with elevated systolic BP, compared with placebo continue to accrue for at least 3 years after cessation of randomized treatment in individuals without cardiovascular disease indicating a legacy effect
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    Multicomponent nursing program to prevent delirium in critically ill patients: A randomized clinical trial
    (2021-10-03) Torres-Contreras, Claudia Consuelo; Paez-Esteban, Astrid Nathalia; Duran-Parra, Myriam; Rincon-Romero, Mayerli Katherine; Giordani da Silva, Carolina; Duarte-Buitrago, Nohora Paola; Everest
    Objectives: To determine the efficacy of a multicomponent nursing program to prevent delirium in critically ill patients. Methods: Parallel controlled randomized clinical trial to prevent delirium in 81 critically ill patients: 41 in the control group and 40 in the intervention group (intervention: spatial and temporal guidance, visual stimulus, auditive stimulus, and family support). Participants were recruited from September 2017 to March 2018 in the university hospital Los Comuneros, Bucaramanga, Colombia. Clinical Trials record NCT03215745. Results: The incidence of delirium was 5% in the intervention group and 24% in the control group. The relative risk was 0.20 (95% CI 0.05 to 0.88). The absolute risk reduction was 19.39% (95% CI 4.61 to 34.17) and the number needed to treat was 5 (95 CI % 3 to 26%). Conclusion: The multicomponent nursing program is efficient to prevent delirium in critically ill patients.
  • Publicación
    Restringido
    Programa de Ejercicio Físico para Resistencia Cardiorrespiratoria y Fuerza de Agarre en Trabajadores, Cúcuta 2023
    (Universidad de Santander, 2024-07-03) Montoya-Lizarazo, Dennis Esmeralda; Flórez-Suárez, Manuel Alejandro; Suárez-Díaz, María Isabel; Blanco-Ramírez, Michelle Andrea; Chaustre-Alvernia, Paula Daniela; Vega-Rincón, Esneyder Alfonso; Rodriguez-Peña, Alejandra del Mar; González - Pérez, Maryely
    En 2016 la Organización Mundial de la Salud y la Organización Internacional del Trabajo informaron que 347.000 personas murieron de cardiopatía isquémica debido a trabajar 55 horas a la semana o más. Esto reveló que la población trabajadora se encuentra expuesta a factores de riesgos cardiovasculares como el sedentarismo, la sobrecarga laboral y las condiciones de trabajo.El objetivo fue establecer los cambios de las cualidades de resistencia cardiorrespiratoria y fuerza de agarre a través de un programa de ejercicio físico en una empresa del sector industrial. Metodología: El enfoque de la investigación fue cuantitativo de tipo cuasiexperimental, se tomó una muestra de 19 trabajadores a los cuales se les evaluó la resistencia cardiorrespiratoria mediante la prueba de la caminata de los 6 minutos y la fuerza de agarre a través de la prueba de dinamometría, posterior a esto se implementó el programa de ejercicio físico durante 12 semanas. Resultados: Se registraron cambios en el 37% de los trabajadores con aptitud Muy Baja, mientras que el 26% con capacidad Baja obtuvo un aumento significativo en su capacidad cardiorrespiratoria, en cuanto a la fuerza de agarre el 47% con capacidad Débil disminuyó significativamente a un 26% y el 53% con aptitud Media se incrementó al 74%. Conclusiones: El programa de ejercicio físico mejora la resistencia y la fuerza de agarre de los trabajadores.