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99: The EPIMIL cohort follow-up : Efficiency of measures leading to lifestyle modifications in metabolic syndrome
Journal of Clinical Lipidology, Vol 2, No 5S, October 2008
Objective: Low adherence to antihypertensive medication remains a public health challenge. Use of lifestyle modification and alternative therapies for blood pressure control and their association with antihypertensive medication adherence among older, insured hypertensive adults are described. Methods: Between August 2006 and September 2007, 2194 participants completed the baseline survey. Antihypertensive medication adherence was assessed with the 8-item Morisky Medication Adherence Scale. Lifestyle modifications to lower blood pressure included weight management, decreasing salt, exercising, decreasing alcohol, and increasing fruits and vegetables. Alternative therapies included use of food and herbal supplements and relaxation techniques. Results: The mean age of participants was 75.0 ± 5.6 years, 30.0% were black, and 58.5% were women. Participants using two or more, versus their counterparts using zero or one, lifestyle modifications for blood pressure control, were less likely to have low medication adherence (adjusted prevalence ratio =0.62; 95% CI: 0.49,0.79). Participants using any alternative therapies were 1.29 (95% CI: 1.04, 1.60) times more likely to have low medication adherence when compared to participants not using alternative therapies. Conclusions: Protective effects of lifestyle modifications and negative effects of alternative therapies on low medication adherence were identified. This information may be useful in developing personalized interventions to improve adherence behaviors in outpatient settings.
Lifestyle modifications are recommended but remain difficult to apply in a wide population. EPIMIL is a prospective epidemiological study including 2045 military personnels. 185 (9%) presented 3 of the 5 criteria of the NCEP ATPIII, and matched with to the MS definition. Corrective measures dealing with dietery measures and physical exercise are initiated, and particularly in patients presenting a MS. A clinical follow-up is organised yearly. After a 2.45 years follow-up for 95% of the population, a significant progression (p<0,00001) of mean weight of 1.16 kg, of waist circumference of 2.6 cm, of systolic blood pressure of 2.6 mmHg and diastolic blood pressure of 1.3 mmHg are observed. There is a significant correlation between variations of weight and systolic blood pressure (r=0.114. p<0.00001). Nevertheless this progression is only observed in the population free for MS at the beginning (weight difference: 1.27±4.4 kg) while weight values are stable in the group initially presenting a MS (weight difference: -0.02±5.3 kg. p<0.00001). This work illustrates that in a population particularly at risk and presenting a MS, the harmful evolution of weight and blood pressure can be controlled by motivation and coaching of these subjects. Nevertheless, a harmful progression of all parameters is observed in the initially healthy population, which underlines the need of enlarging and reinforcing the therapeutic education to all the subjects. Funding: none
Funding: National Institutes of Health 100 99 THE EPIMIL COHORT FOLLOW-UP : EFFICIENCY OF MEASURES LEADING TO LIFESTYLE MODIFICATIONS IN METABOLIC SYNDROME L. Bordier1, C. Garcia1, H. Mayaudon1, F. Ceppa2, O. Dupuy1, J.P. Le Berre1, B. Bauduceau1. 1Endocrinology Department Begin Hospital, Saint-Mandé, France, 2Biochemistry Department Begin Hospital, Saint-Mandé, France The epidemic of obesity and metabolic syndrome (MS) interests France as much as the whole world.
FREQUENCY OF SEVERE VALVULAR DISEASE CAUSED BY MEDIASTINAL RADIATION AMONG PATIENTS UNDERGOING VALVE SURGERY IN A COMMUNITY HOSPITAL K.A. Copeland, V.R. Hosmane, M.K. Banbury, J.F. Strasser, A.J. Doorey. Christiana Care Health System-Department of Cardiology, Newark, NJ, USA Objective: Mediastinal radiation is used to treat various malignancies, but can cause late cardiac complications. Secondary valve injury, which is not
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Objective: Low adherence to antihypertensive medication remains a public health challenge. Use of lifestyle modification and alternative therapies for blood pressure control and their association with antihypertensive medication adherence among older, insured hypertensive adults are described. Methods: Between August 2006 and September 2007, 2194 participants completed the baseline survey. Antihypertensive medication adherence was assessed with the 8-item Morisky Medication Adherence Scale. Lifestyle modifications to lower blood pressure included weight management, decreasing salt, exercising, decreasing alcohol, and increasing fruits and vegetables. Alternative therapies included use of food and herbal supplements and relaxation techniques. Results: The mean age of participants was 75.0 ± 5.6 years, 30.0% were black, and 58.5% were women. Participants using two or more, versus their counterparts using zero or one, lifestyle modifications for blood pressure control, were less likely to have low medication adherence (adjusted prevalence ratio =0.62; 95% CI: 0.49,0.79). Participants using any alternative therapies were 1.29 (95% CI: 1.04, 1.60) times more likely to have low medication adherence when compared to participants not using alternative therapies. Conclusions: Protective effects of lifestyle modifications and negative effects of alternative therapies on low medication adherence were identified. This information may be useful in developing personalized interventions to improve adherence behaviors in outpatient settings.
Lifestyle modifications are recommended but remain difficult to apply in a wide population. EPIMIL is a prospective epidemiological study including 2045 military personnels. 185 (9%) presented 3 of the 5 criteria of the NCEP ATPIII, and matched with to the MS definition. Corrective measures dealing with dietery measures and physical exercise are initiated, and particularly in patients presenting a MS. A clinical follow-up is organised yearly. After a 2.45 years follow-up for 95% of the population, a significant progression (p<0,00001) of mean weight of 1.16 kg, of waist circumference of 2.6 cm, of systolic blood pressure of 2.6 mmHg and diastolic blood pressure of 1.3 mmHg are observed. There is a significant correlation between variations of weight and systolic blood pressure (r=0.114. p<0.00001). Nevertheless this progression is only observed in the population free for MS at the beginning (weight difference: 1.27±4.4 kg) while weight values are stable in the group initially presenting a MS (weight difference: -0.02±5.3 kg. p<0.00001). This work illustrates that in a population particularly at risk and presenting a MS, the harmful evolution of weight and blood pressure can be controlled by motivation and coaching of these subjects. Nevertheless, a harmful progression of all parameters is observed in the initially healthy population, which underlines the need of enlarging and reinforcing the therapeutic education to all the subjects. Funding: none
Funding: National Institutes of Health 100 99 THE EPIMIL COHORT FOLLOW-UP : EFFICIENCY OF MEASURES LEADING TO LIFESTYLE MODIFICATIONS IN METABOLIC SYNDROME L. Bordier1, C. Garcia1, H. Mayaudon1, F. Ceppa2, O. Dupuy1, J.P. Le Berre1, B. Bauduceau1. 1Endocrinology Department Begin Hospital, Saint-Mandé, France, 2Biochemistry Department Begin Hospital, Saint-Mandé, France The epidemic of obesity and metabolic syndrome (MS) interests France as much as the whole world.
FREQUENCY OF SEVERE VALVULAR DISEASE CAUSED BY MEDIASTINAL RADIATION AMONG PATIENTS UNDERGOING VALVE SURGERY IN A COMMUNITY HOSPITAL K.A. Copeland, V.R. Hosmane, M.K. Banbury, J.F. Strasser, A.J. Doorey. Christiana Care Health System-Department of Cardiology, Newark, NJ, USA Objective: Mediastinal radiation is used to treat various malignancies, but can cause late cardiac complications. Secondary valve injury, which is not
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