European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).

Department of Cardiology, The Adelaide and Meath Hospital, Tallaght, Dublin, Ireland.
European Journal of Cardiovascular Prevention and Rehabilitation (Impact Factor: 3.69). 10/2007; 14 Suppl 2:S1-113. DOI: 10.1097/01.hjr.0000277983.23934.c9
Source: PubMed
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    ABSTRACT: Exercise is an essential component of contemporary cardiac rehabilitation programs for the secondary prevention of coronary heart disease. Despite the benefits associated with regular exercise, adherence with supervised exercise-based cardiac rehabilitation remains low. Increasingly powerful mobile technologies, such as smartphones and wireless physiological sensors, may extend the capability of exercise-based cardiac rehabilitation by enabling real-time exercise monitoring for those with coronary heart disease. This study compares the effectiveness of technology-assisted, home-based, remote monitored exercise-based cardiac rehabilitation (REMOTE) to standard supervised exercise-based cardiac rehabilitation in New Zealand adults with a diagnosis of coronary heart disease. A two-arm, parallel, non-inferiority, randomised controlled trial will be conducted at two sites in New Zealand. One hundred and sixty two participants will be randomised at a 1:1 ratio to receive a 12-week program of technology-assisted, home-based, remote monitored exercise-based cardiac rehabilitation (intervention), or an 8-12 program of standard supervised exercise-based cardiac rehabilitation (control).The primary outcome is post-treatment maximal oxygen uptake (VO2max). Secondary outcomes include cardiovascular risk factors (blood lipid and glucose concentrations, blood pressure, anthropometry), self-efficacy, intentions and motivation to be active, objectively measured physical activity, self-reported leisure time exercise and health-related quality of life. Cost information will also be collected to compare the two modes of delivery. All outcomes are assessed at baseline, post-treatment, and 6 months, except for VO2max, blood lipid and glucose concentrations, which are assessed at baseline and post-treatment only. This novel study will compare the effectiveness of technology-supported exercise-based cardiac rehabilitation to a traditional supervised approach. If the REMOTE program proves to be as effective as traditional cardiac rehabilitation, it has potential to augment current practice by increasing access for those who cannot utilise existing services.Trial registration: Australian New Zealand Clinical Trials RegistryStudy ID number: ACTRN12614000843651. Registered 7 August 2014.
    BMC Public Health 11/2014; 14(1):1236. DOI:10.1186/1471-2458-14-1236 · 2.32 Impact Factor
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    ABSTRACT: Introduction. The quality of life depends on physical, psychological and social factors that are evidently influenced by the individual's actions, prospect, attitude and behavior. Heart disease is one of the most imperative health problems in the world. Studies showed that exercise-based rehabilitation for patients with coronary artery disease effectively lowers the rate of cardiac death. The intent of this study was to determine the effects of physical activity on the life quality of cardiovascular patients after coronary artery bypass graft. Materials and Methods. This randomized clinical trial was performed on two groups of coronary artery patients of Yazd Afshar hospital. All the 70 participants were post surgery coronary artery patients who were divided into two groups. Data was collected by two questionnaires: A personal information questionnaire and a quality of life questionnaire (SF=36). Data of both groups was collected in the first and fourth month after the discharge from surgery and sessions were analyzed by SPSS 16 and by using T-test and Chi-square. Results. Results displayed that after the intervention, all the categories of the components of the quality of life were increased except for general health. There was no significant differentiation between these statuses in the control group and the premier grades about the components of the social function (88.98 out of 100). The comparison of total scores of the quality of life before the intervention showed the quality of life of both groups one month after surgery was not significant (p=75%), but in four months after surgery, the distinction between the mean grade scores of the intervention, the group was considerable (p=0.0001). Conclusion. The comparison of the total scores of the quality of life indicated an increase in the scores of the quality of life in the intervention group after the exercise.
    Journal of medicine and life 06/2014; 7(2):260-3.
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    ABSTRACT: GPs need accurate tools for cardiovascular (CV) risk assessment. Abnormalities in resting electrocardiograms (ECGs) relate to increased CV risk. To determine whether measurement of ECG abnormalities on top of established risk estimation (SCORE) improves CV risk classification in a primary care population. A cohort study of patients enlisted with academic general practices in the Netherlands (the Utrecht Health Project [UHP]). Incident CV events were extracted from the GP records. MEANS algorithm was used to assess ECG abnormalities. Cox proportional hazards modelling was applied to relate ECG abnormalities to CV events. For a prediction model only with SCORE variables, and a model with SCORE+ECG abnormalities, the discriminative value (area under the receiver operator curve [AUC]) and the net reclassification improvement (NRI) were estimated. A total of 2370 participants aged 38-74 years were included, all eligible for CV risk assessment. During a mean follow-up of 7.8 years, 172 CV events occurred. In 19% of the participants at least one ECG abnormality was found (Lausanne criteria). Presence of atrial fibrillation/flutter (AF) and myocardial infarction (MI) were significantly related to CV events. The AUC of the SCORE risk factors was 0.75 (95% CI = 0.71 to 0.79). Addition of MI or AF resulted in an AUC of 0.76 (95% CI = 0.72 to 0.79) and 0.75 (95% CI = 0.72 to 0.79), respectively. The NRI with the addition of ECG abnormalities was small (MI 1.0%; 95% CI = -3.2% to 6.9%; AF 0.5%; 95% CI = -3.5% to 3.3%). Performing a resting ECG in a primary care population does not seem to improve risk classification when SCORE information - age, sex, smoking, systolic blood pressure, and total cholesterol/HDL ratio - is already available. © British Journal of General Practice 2015.
    British Journal of General Practice 01/2015; 65(630):e1-8. DOI:10.3399/bjgp15X683089 · 2.36 Impact Factor