Recent Advances in Preventive Cardiology and Lifestyle Medicine A Themed Series

Departments of Medicine and Cardiology, Cardiac Rehabilitation and Exercise Laboratories, William Beaumont Hospital, Royal Oak, MI 48073, USA.
Circulation (Impact Factor: 14.95). 05/2011; 123(20):2274-83. DOI: 10.1161/CIRCULATIONAHA.110.981613
Source: PubMed
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    ABSTRACT: There are alarming increases in the incidence of obesity, insulin resistance, type II diabetes, and cardiovascular disease. The risk of these diseases is significantly reduced by appropriate lifestyle modifications such as increased physical activity. However, the exact mechanisms by which exercise influences the development and progression of cardiovascular disease are unclear. In this paper we review some important exercise-induced changes in cardiac, vascular, and blood tissues and discuss recent clinical trials related to the benefits of exercise. We also discuss the roles of boosting antioxidant levels, consequences of epicardial fat reduction, increases in expression of heat shock proteins and endoplasmic reticulum stress proteins, mitochondrial adaptation, and the role of sarcolemmal and mitochondrial potassium channels in the contributing to the cardioprotection offered by exercise. In terms of vascular benefits, the main effects discussed are changes in exercise-induced vascular remodeling and endothelial function. Exercise-induced fibrinolytic and rheological changes also underlie the hematological benefits of exercise.
    05/2012; 2012:210852. DOI:10.1155/2012/210852
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    ABSTRACT: Poor nutrition in the first year of a mother's life and undernutrition in utero, infancy, childhood, and adulthood predispose individuals to stroke in later life, but the mechanism of increased stroke risk is unclear. Overnutrition also increases the risk of stroke, probably by accelerating the development of obesity, hypertension, hyperlipidaemia, and diabetes. Reliable evidence suggests that dietary supplementation with antioxidant vitamins, B vitamins, and calcium does not reduce the risk of stroke. Less reliable evidence suggests that stroke can be prevented by diets that are prudent, aligned to the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) diets, low in salt and added sugars, high in potassium, and meet, but do not exceed, energy requirements. Trials in progress are examining the effects of vitamin D and marine omega-3 fatty acid supplementation on incidence of stroke. Future challenges include the need to improve the quality of evidence linking many nutrients, foods, and dietary patterns to the risk of stroke.
    The Lancet Neurology 01/2012; 11(1):66-81. DOI:10.1016/S1474-4422(11)70265-4 · 21.82 Impact Factor
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    ABSTRACT: Background: Lifestyle modification programmes for coronary heart disease patients have been shown to effectively improve risk factors and related health behaviours, quality of life, reincidence, and mortality. However, improvements in routine cardiac care over the recent years may offset the incremental benefit associated with older programmes.Purpose: To determine the efficacy of lifestyle modification programmes for coronary heart disease patients developed over the last decade (1999-2009) by means of a systematic review and meta-analysis.Results: The study included 23 trials (involving 11,085 randomized patients). Lifestyle modification programmes were associated with reduced all-cause mortality (summary OR 1.34, 95% CI 1.10-1.64), cardiac mortality (summary OR 1.48, 95% CI 1.17-1.88), and cardiac readmissions and non-fatal reinfarctions (summary OR 1.35, 95% CI 1.17-1.55). Furthermore, lifestyle modification programmes positively affected risk factors and related lifestyle behaviours at posttreatment (M = 10.2 months), and some of these benefits were maintained at long-term follow up (M = 33.7 months). Improvements in dietary and exercise behaviour were greater for programmes incorporating all four self-regulation techniques (i.e. goal setting, self-monitoring, planning, and feedback techniques) compared to interventions that included none of these techniques.Conclusion: The evidence summarized in this meta-analysis confirms the benefits of lifestyle modification programmes - over and above benefits achieved by routine clinical care alone.
    09/2012; 20(4). DOI:10.1177/2047487312462824