Association of worksite wellness center attendance with weight loss and health care cost savings: Mayo Clinic's experience.

Objective: To assess the impact of wellness center attendance on weight loss and costs.

Methods: A retrospective analysis was conducted using employee data, administrative claims, and electronic health records. A total of 3199 employees enrolled for 4 years (2007 to 2010) were included.

Trends and predictors of smoking cessation after percutaneous coronary intervention (from Olmsted County, Minnesota, 1999 to 2010).

Smoke-free ordinance implementation and advances in smoking cessation (SC) treatment have occurred in the past decade; however, little is known about their impact on SC in patients with coronary artery disease. We conducted a retrospective cohort study of 2,306 consecutive patients from Olmsted County, Minnesota, who underwent their first percutaneous coronary intervention (PCI) from 1999 to 2009, and assessed the trends and predictors of SC after PCI. Smoking status was ascertained by structured telephone survey 6 and 12 months after PCI (ending in 2010).

Impact of chronic changes in arterial compliance and resistance on left ventricular ageing in humans.

Aims: Left ventricular systolic elastance (Ees) and diastolic elastance (Eed) correlate with arterial elastance (Ea), but it is unknown how chronic changes in arterial compliance and resistance, which determine Ea, might differentially affect cardiac properties with ageing. We sought to characterize chronic changes in pulsatile and resistive arterial load and correlate them with longitudinal changes in LV structure and function in a prospective, community-based study.

Methods And Results: Comprehensive echocardiography was performed in 722 subjects participating in a randomly selected community-based study at two examinations separated by 4 years, allowing for assessment of LV Ees, Eed, and end-diastolic volume (EDV), Ea, total arterial compliance, and systemic vascular resistance at both examinations.

Normal-weight obesity: implications for cardiovascular health.

We sought to review the epidemiological features and clinical implications of normal-weight obesity. The concept of normal-weight obesity has been recently reported as an important risk factor for cardiovascular disease, metabolic dysregulation, and poor functional outcomes. However, in clinical practice, normal-weight obesity is not commonly recognized.

Increased cardio-ankle vascular index in hyperlipidemic patients without diabetes or hypertension.

Aim: The cardio-ankle vascular index (CAVI) is a sensitive non-invasive marker of arterial stiffness and atherosclerosis. The aim of this work was to compare the CAVI values in patients with dyslipidemia (without diabetes mellitus and hypertension) and healthy controls.

Methods: A Total 248 subjects with dyslipidemia (104 men, 144 women), 55.

The Hispanic paradox in cardiovascular disease and total mortality.

Health statistics and epidemiologic studies have shown that Hispanics live longer than Non Hispanic Whites, despite a high prevalence of cardiovascular disease (CVD) risk factors and an average low socioeconomic status, both strong predictors of CVD and mortality. This phenomenon has been dubbed "The Hispanic paradox" and has been demonstrated in old and contemporary cohorts. To date, no factor has been identified that could explain this phenomenon, but socio demographic factors, dietary intake and genetic predisposition have been proposed as possible explanations for the Hispanic paradox.

Cardiac rehabilitation in Latin America.

This article provides a description of the status of cardiovascular (CV) rehabilitation (CVR) in Latin America (LA) and the potential impact on CV disease in the region. We discuss the insufficient number of CVR programs in the region and describe the components of CVR that are more commonly available, like exercise interventions, medical assessment and patient education. Additionally, we discuss the heterogeneity in other components, like the evaluation of depression, sleep apnea, and smoking cessation programs.

The prognostic importance of weight loss in coronary artery disease: a systematic review and meta-analysis.

Objective: To assess the prognostic impact of weight loss on clinical outcomes in patients with coronary artery disease (CAD).

Methods: We performed a systematic review and meta-analysis of the prognostic effects of weight loss in patients with CAD on a composite outcome of all-cause mortality, cardiovascular mortality, and major adverse cardiac events considering studies published between January 1, 1964, and August 8, 2013. We considered weight loss "intentional" when it occurred in the presence of programmed therapeutic lifestyle changes and "observational" when no such intervention was specified.

Impact of general and central adiposity on ventricular-arterial aging in women and men.

Objectives: The aim of this study was to assess the effects of central and general obesity measures on long-term longitudinal changes in ventricular-arterial mechanics.

Background: Obesity, female sex, and ventricular-arterial stiffening are associated with the development of heart failure with preserved ejection fraction. Fat distribution and chronic changes in body composition may affect longitudinal changes in LV properties, independent of arterial load.

Influence of body fatness distribution and total lean mass on aortic stiffness in nonobese individuals.

Background: Subjects with normal body mass index but high body fat percentage have higher cardiovascular risk than subjects with normal weight and low fat mass. However, the association of fat distribution and lean mass with carotid-femoral pulse wave velocity (cfPWV) among nonobese apparently healthy individuals has never been assessed.

Methods: In 136 nonobese volunteers (mean age = 45±9 years; 57% women) without manifest cardiovascular disease, cfPWV was measured by applanation tonometry.

A summary and critical assessment of the 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: filling the gaps.

The American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines has recently released the new cholesterol treatment guideline. This update was based on a systematic review of the evidence and replaces the previous guidelines from 2002 that were widely accepted and implemented in clinical practice. The new cholesterol treatment guideline emphasizes matching the intensity of statin treatment to the level of atherosclerotic cardiovascular disease (ASCVD) risk and replaces the old paradigm of pursuing low-density lipoprotein cholesterol targets.

A perspective on the New American College of Cardiology/American Heart Association guidelines for cardiovascular risk assessment.

The recently published American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for cardiovascular risk assessment provide equations to estimate the 10-year and lifetime atherosclerotic cardiovascular disease (ASCVD) risk in African Americans and non-Hispanic whites, include stroke as an adverse cardiovascular outcome, and emphasize shared decision making. The guidelines provide a valuable framework that can be adapted on the basis of clinical judgment and individual/institutional expertise. In this review, we provide a perspective on the new guidelines, highlighting what is new, what is controversial, and potential adaptations.

Waist Circumference, Physical Activity, and Functional Impairments in Older U.S. Adults: Results from the NHANES 2005-2010.

Physical activity (PA) improves function in older obese adults. However, body mass index is an unreliable adiposity indicator better reflected by waist circumference (WC). The impact of PA on physical impairment and mobility with high WC is unclear.

The current and potential capacity for cardiac rehabilitation utilization in the United States.

Purpose: Prior studies suggest that program capacity restraints may be an important reason for outpatient cardiac rehabilitation (CR) underutilization. We sought to measure current CR capacity and growth potential.

Methods: We surveyed all CR program directors listed in the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) database in November 2012.

Predicting long-term cardiovascular risk using the mayo clinic cardiovascular risk score in a referral population.

Exercise testing provides valuable information but is rarely integrated to derive a risk prediction model in a referral population. In this study, we assessed the predictive value of conventional cardiovascular risk factors and exercise test parameters in 6,546 consecutive adults referred for exercise testing, who were followed for a period of 8.1 ± 3.

Relationship of body mass index with total mortality, cardiovascular mortality, and myocardial infarction after coronary revascularization: evidence from a meta-analysis.

Objective: To investigate the relationship of body mass index (BMI) with total mortality, cardiovascular (CV) mortality, and myocardial infarction (MI) after coronary revascularization procedures (coronary artery bypass grafting [CABG] and percutaneous coronary intervention [PCI]).

Patients And Methods: Systematic search of studies was conducted using PubMed, CINAHL, Cochran CENTRAL, Scopus, and the Web of Science databases. We identified studies reporting the rate of MI, CV mortality, and total mortality among coronary artery disease patients' postcoronary revascularization procedures in various BMI categories: less than 20 (underweight), 20-24.

Relationship between measures of central and general adiposity with aortic stiffness in the general population.

Objective: Increased aortic stiffness may be one of the mechanisms by which obesity increases cardiovascular risk independently of traditional risk factors. While body mass index (BMI) is generally used to define excess adiposity, several studies have suggested that measures of central obesity may be better predictors of cardiovascular risk. However, data comparing the association between several measures of central and general obesity with aortic stiffness in the general population are inconclusive.

Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis.

Background: The ideal means of identifying obesity in children and adolescents has not been determined although body mass index (BMI) is the most widely used screening tool.

Objective: We performed a systematic review and meta-analysis of studies assessing the diagnostic performance of BMI to detect adiposity in children up to 18 years.

Methods: Data sources were EMBASE, MEDLINE, Cochrane, Database of Systematic Reviews Cochrane CENTRAL, Web of Science and SCOPUS up to March 2013.

Sarcopenia, sarcopenic obesity and mortality in older adults: results from the National Health and Nutrition Examination Survey III.

Background: Sarcopenia is defined as the loss of skeletal muscle mass and quality, which accelerates with aging and is associated with functional decline. Rising obesity prevalence has led to a high-risk group with both disorders. We assessed mortality risk associated with sarcopenia and sarcopenic obesity in elders.

Normal weight obesity and functional outcomes in older adults.

Background: Obesity defined by body mass index (BMI) is associated with higher levels of functional impairment. However, BMI strata misrepresent true adiposity, particularly in those with a normal BMI but elevated body fat (BF%) (normal weight obesity [NWO]) whom are at higher metabolic and mortality risk. Whether this subset of patients is associated with worsening functional outcomes is unclear.

Inpatient rehabilitation outcomes for patients receiving left ventricular assist device.

Objective: The aim of this study was to evaluate outcomes of patients participating in inpatient rehabilitation program after left ventricular assist device (LVAD) implantation.

Design: Medical records of 94 patients who received LVADs between January 1, 2008, and June 30, 2010, at the Mayo Clinic in Rochester, MN, were retrospectively reviewed for demographic data, and inpatient rehabilitation functional outcomes were measured by the Functional Independence Measure scale.

Results: After successful implantation of LVAD, the patients were either discharged directly home from acute care (44%) or admitted to inpatient rehabilitation (56%).