Physical Activity, All-Cause and Cardiovascular Mortality, and Cardiovascular Disease.

Purpose: Conduct a systematic umbrella review to evaluate the relationship of physical activity (PA) with all-cause mortality, cardiovascular mortality, and incident cardiovascular disease (CVD); to evaluate the shape of the dose-response relationships; and to evaluate these relationships relative to the 2008 Physical Activity Guidelines Advisory Committee Report.

Methods: Primary search encompassing 2006 to March, 2018 for existing systematic reviews, meta-analyses, and pooled analyses reporting on these relationships. Graded the strength of evidence using a matrix developed for the Physical Activity Guidelines Advisory Committee.

Transformative practices for integrating mind-body-spirit.

This paper explores the clinical use of transformative practices that arose from the varied religious traditions of the world. Examples include prayer, meditation, mantra, affirmation, tai chi, and yoga. The purpose of these practices was to lead the practitioner to long term spiritual transformation toward an enhanced awareness of spirit, and a corresponding diminishment of identification with the mental and physical aspects of life.

Successful dietary changes in a cardiovascular risk reduction intervention are differentially predicted by biopsychosocial characteristics.

Background: Psychosocial factors have demonstrated associations with both prognosis of patients with cardiovascular disease (CVD) as well as the development of CVD. Psychosocial distress may influence health behaviors (such as eating behavior) that increase cardiovascular risk.

Method: The purpose of this research was to evaluate the role of psychosocial distress on intake of high-fat snacks and fruits and vegetables in 740 men and women, identified as high risk for cardiovascular disease, who took part in a 1-year cardiovascular risk factor reduction program.

Trends in Prescribing of Selective Serotonin Reuptake Inhibitors and Other Newer Antidepressant Agents in Adult Primary Care.

BACKGROUND: The introduction of selective serotonin reuptake inhibitors (SSRIs) represented a breakthrough in depression treatment due to their safety and ease of use. The purpose of this study was to extend previous work on trends in antidepressant use to include recent data and to provide more detailed analysis of prescribing trends for SSRIs and newer non-SSRI antidepressants, specifically in adult primary care practice. METHOD: Adult primary care visits from the National Ambulatory Medical Care Survey (NAMCS) between 1989 and 2000 were analyzed.

Depression and the metabolic syndrome in young adults: findings from the Third National Health and Nutrition Examination Survey.

Objective: Previous reports have suggested that depression may lead to the development of cardiovascular disease through its association with the metabolic syndrome; however, little is known about the relationship between depression and the metabolic syndrome. The aim of this study was to establish an association between depression and the metabolic syndrome in a nationally representative sample.

Methods: The Third National Health and Nutrition Examination Survey is a population-based health survey of noninstitutionalized US citizens completed between 1988 and 1994.

Do behavioral disturbances in persons with Alzheimer's disease predict caregiver depression over time?

Random effects models were used to examine the association between behavioral disturbances in persons with Alzheimer's disease (N = 90) and caregiver depressive symptoms at 2-month intervals over an 18-month period. There was substantial variability in trajectories of change in caregiver depressive symptoms over time but no systematic increase in distress despite increased severity of dementia symptoms. Total behavioral disturbances were associated with higher levels of caregiver depressive symptoms: this effect was primarily attributable to aggressive behaviors.

National Patterns of Medication Treatment for Depression, 1987 to 2001.

BACKGROUND: We investigated trends in antidepressant use, as well as broader changes in depression treatment, following the availability of selective serotonin reuptake inhibitors (SSRIs). METHOD: Using data from the National Disease and Therapeutic Index, a nationally representative survey of U.S.

Risk factors for progression to incident hyperinsulinemia: the Atherosclerosis Risk in Communities Study, 1987-1998.

Hyperinsulinemia is a marker of insulin resistance, a correlate of the metabolic syndrome, and an established precursor of type 2 diabetes. This US study investigated the role of risk factors associated with hyperinsulinemia in cross-sectional studies in progression to incident hyperinsulinemia. Nondiabetic participants from the Atherosclerosis Risk in Communities Study (n = 9,020) were followed from 1987 to 1998 for the development of hyperinsulinemia (fasting serum insulin > or = 90th percentile, 19.

Association between microalbuminuria and the metabolic syndrome: NHANES III.

We investigated whether microalbuminuria was associated with the metabolic syndrome by comparing the strength of the association between microalbuminuria and the syndrome as a whole and its individual components. This investigation included 5659 women and men aged 20 to 80 years from the cross-sectional, nationally representative, Third National Health and Nutrition Examination Survey (NHANES III: 1988-1994). Metabolic syndrome was defined as any three of the following: increased waist circumference, increased triglycerides, decreased HDL cholesterol, increased blood pressure, or high fasting glucose.

Soy, garlic, and ginkgo biloba: their potential role in cardiovascular disease prevention and treatment.

There are hundreds of foods, nutrients, herbs, and botanicals that have "bioactive" constituents with potential human health benefits. Three of these are discussed in this review: soy, garlic, and ginkgo biloba. Each of these three choices involves an ingestible item composed of a complex mixture of bioactive agents.

The effect of lifestyle interventions on quality of life and patient satisfaction with health and health care.

Improvements in quality of life (QOL) and high levels of patient satisfaction are associated with cardiovascular risk reduction (CRR) programs. Understanding the influences that lifestyle change and medical management have on individuals, their families, and their environment can help target successful interventions that benefit both QOL and patient satisfaction. It is well known that multiple aspects of one's QOL can be affected by the development of coronary artery disease.

Cardiovascular disease prevention and lifestyle interventions: effectiveness and efficacy.

Over the past half century scientific data support the strong relationship between the way a person or population lives and their risk for developing or dying from cardiovascular disease (CVD). While heredity can be a major factor for some people, their personal health habits and environmental/cultural exposure are more important factors. CVD is a multifactor process that is contributed to by a variety of biological and behavioral characteristics of the person including a number of well-established and emerging risk factors.

Treatment options for patients with the metabolic syndrome.

Purpose: To review clinical and laboratory findings that will enhance nurse practitioner (NP) recognition of the metabolic syndrome and to increase awareness of recent treatment guidelines and treatment options.

Data Sources: Professional association practice guidelines, government documents, original research articles, and journal articles.

Conclusions: The metabolic syndrome is a prevalent condition characterized by a cluster of lipid and nonlipid abnormalities, including atherogenic dyslipidemia, elevated fasting blood glucose, hypertension, and abdominal obesity.

Symptoms of depression as a risk factor for incident diabetes: findings from the National Health and Nutrition Examination Epidemiologic Follow-up Study, 1971-1992.

Symptoms of depression may predict incident diabetes independently or through established risk factors for diabetes. US men and women aged 25-74 years who were free of diabetes at baseline (n = 6,190) were followed from 1971 to 1992 (mean, 15.6 years; standard deviation, 6) for incident diabetes.

A prospective evaluation of the risk of QT prolongation with hormone replacement therapy: the atherosclerosis risk in communities study.

Purpose: Prolongation of the QT interval is associated with an increased risk of arrhythmia, coronary heart disease (CHD), and mortality. Estrogens and androgens have been proposed as a causal factor in QT lengthening. We tested whether postmenopausal hormone replacement therapy was associated with prolonged QT intervals in a healthy population sample of women (mean age=54).

Cancer-related health behaviors and screening practices among Latinos: findings from a community and agricultural labor camp survey.

Objective: To examine whether cancer-related health behaviors and screening practices differ within a population of Latino adults, including those often missed by cancer surveys.

Design: Cross-sectional survey, conducted in 2000. Sample of 461 women and 356 men from the community (75% with unlisted telephones) and 188 men from agricultural labor camps, 18-64 years of age.

Prospective association between hormone replacement therapy, heart rate, and heart rate variability. The Atherosclerosis risk in communities study.

Hormone replacement therapy is universally associated with coronary heart disease (CHD) in observational studies, but it is unknown whether this association is mediated by the autonomic nervous system. We tested the hypothesis that postmenopausal hormone replacement therapy was associated with more favorable heart rate (HR) and heart rate variability (HRV) in a population sample of women (n=2,621). Hormone therapy use was measured at four examinations beginning in 1987.

A statistical analysis of the magnitude and composition of drug promotion in the United States in 1998.

Background: Although pharmaceutical industry marketing and other factors may influence physician decisions regarding medication prescribing in the United States, little information is available about the composition of promotional efforts by promotional mode and medication class.

Objectives: The aims of this study were to determine the magnitude of expenditures for common modes of promotion and to delineate patterns of promotional strategies for particular classes of medications.

Methods: Nationally representative data on expenditures (in US $) for the 250 most promoted medications in the United States in 1998 were available from an independent pharmaceutical market research company for the 5 most commonly used modes of promotion.

Cardiovascular risk factor modification: is it effective in older adults?

Older adults over the age of 65 are the fastest growing segment of the US population. However, the prevalence of cardiovascular disease (CVD) is highest in this population and CVD is the primary cause of death for elders. Cardiovascular disease risk factors are similar for both younger and older age groups and include hypertension, cigarette smoking, hyperlipidemia, and diabetes.

Chronic disease medication use in managed care and indemnity insurance plans.

Objective: To evaluate the impact of managed care on the use of chronic disease medications.

Data Source: Claims data from 1997 from two indemnity and three independent practice association (IPA) model managed care insurance plans.

Research Design: Cross-sectional analysis of claims data.

Age differences in symptoms of depression and anxiety: examining behavioral medicine outpatients.

This study examined whether symptoms of depression and concomitant anxiety differed between older and younger medical outpatients referred to a behavioral medicine clinic. In a sample of 178 male veterans aged 21-83 years, older adults (> or = 60 years) reported lower overall depressive symptoms on the Beck Depression Inventory (BDI) and anxiety symptoms on the State-Trait Anxiety Inventory than did younger adults ( < 60 years). Depressive symptoms were highly prevalent.

Influence of individual and neighbourhood socioeconomic status on mortality among black, Mexican-American, and white women and men in the United States.

Study Objective: s: This study examines the influence of individual and neighbourhood socioeconomic status (SES) on mortality among black, Mexican-American, and white women and men in the US. The authors had three study objectives. Firstly, they examined mortality rates by both individual level SES (measured by income, education, and occupational/employment status) and neighbourhood level SES (index of neighbourhood income/wealth, educational attainment, occupational status, and employment status).

National trends in antiobesity medication use.

Background: The use of medications to treat obesity remains controversial. Our goal was to assess national trends in antiobesity medication use with a focus on patterns surrounding the 1997 removal of antiobesity drugs from the market.

Methods: Using a serial cross-sectional study design, we analyzed a nationally representative sample of US office-based physician visits from 1991 to 2002.

Dance and reducing television viewing to prevent weight gain in African-American girls: the Stanford GEMS pilot study.

Objective: To test the feasibility, acceptability, and potential efficacy of after-school dance classes and a family-based intervention to reduce television viewing, thereby reducing weight gain, among African-American girls.

Design: Twelve-week, 2-arm parallel group, randomized controlled trial.

Setting: Low-income neighborhoods.