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Effects of cardiac rehabilitation and exercise training on exercise capacity and body mass index in women
Thursday June 29, 2000: Read by l~tle Abstracts T."W31 Prevention of CVD examined for hyperlipidemia, diabetes mellitus and hypertension in our Internal Medicine Unit. The subjects enrolled filled in a questionnaire conceming personal and familial CVD, smoking habits and drug consumption and received also ABPM, ECG, echocardiogram and echoDoppler of carotid arteries. Results: In all patients, but not one, the hypertension was confirmed by ABPM. No patients showed secondary hypertension. Among hypertensives, 14 were aware of their condition but only 3 were treated. Thirteen patients were found to have hyperlipidemia and 2 to have diabetes mellitus. Only 5 of patients with hyperlipidemia were aware of their condition, no one were treated. The 2 diabetic patients were aware of their condition, they were treated and they had HbA1C levels > 7%. Conclusions: Although we reported preliminary data, our findings show that, in these selected patients, the awareness and the control of risk factors tor CVD is neglected. Indeed, an approach by physicians and screening program might be of help to improve the awareness of the risk factors for CVD.
315
Hypertensives Mean 4- SD
Normotensives Mean 4- SD
95% CI
P
Nutrients Energy (Kcal) Protein (gr) Carbohydrate (gr) Cholesterol (mg) Fat (gr) SFA (gr) MUFA (gr) PUFA (gr)
2251.6 4- 982.3 76.9 + 29.2 327.5 4- 123.0 225.8 4- 158.4 71.9 4- 65.5 32.6 4- 38.4 23.2 4- 20.5 12.34 4- 10.2
2522.6 4- 1271.5 82.3 4- 3 3 3 362.3 4- 225.7 273.1 4- 190.4 83.6 4- 47.6 37.3 4- 21.9 26.8 4- 15.0 15.2 4- 13.5
117.1,424.8 1.28, 9.6 9.02, 60.6 25.4, 69.3 4.7, 18.6 1.07, 8.36 1.43, 5.82 1.42, 4.4
0.00l 0.01 0.008 0.000 0.001 0.011 0.001 0.000
in hypertensives than normotensives but only cholesterol intake can be a contributor dietary factors for hypertension in Iranian population.
ThT12:W31 ] Effets of cardiac rehabilitation and exercise training on
exercise capacity and body mass index in women K. Rabiei, J. Najafian. Isfahan Cardiovascular Research Center, lsfahan, /ran
3
ThT10:W31 ] Cardiovascular risk factors analysis in patients with
sudden death after acute myocardial infarction Gabriela Ciobotaru, D. Burghina, Deliana Vasiluta, R. Popa, Minodora Mihalas, Anca Isac, Oana Tunea, C. Domide, I.A. Rivis. 1st Internal Medicine Clinic - City Hospital Timisoara, Romania The present work aimed to correlate the risk factors in acute myocardial infarction (AMI) patients and their role in appearance and control of sudden death. Material and Method: We studied 174 patients with AMI, which presented sudden death, hospitalized between 1995-1999. There was analyzed: the existence of the risk factors with predictive value for the sudden death, the heart hypertrophy - dilatation, EKG aspects. Results: 31.5% from the patients were successfully resuscitated after ventricular fibrillation (20 patients) and after ventricular tachycardia (4 patients). The location of AMI in surviving patients was 50% inferior, 37.5% anterior, 12.5% non-Q. The average age was 54.5 in surviving patients and 66.1% in deceaseds. The risk factors for the unsuccessfully resuscitation were: male (Odds Ratio: OR = 1.12, and Relative Risk: RR = 1.03); age over 60 years (OR = 10.4 and RR = 3.92); the anterior location of AMI as compared to inferior location (OR = 36, RR = 4.88); the presence of hypertrophied-dilated heart (OR = 2.24, RR = 1.29). Patients invasive treated (PTCA, stent or CABG) and their rate of survival at 1 year was 75% as compared to 41.6% in patients medical treated. The rate of survival was less than 6 month in patients with dilated heart. Conclusions: Risk factors synergy increases the sudden death risk in young persons, males, aged over 60, anterior location of AMI. Cardiac dilation reduced postresuscitation survival less than 3 month. Ventricular fibrillation was the main mechanism of sudden death in resuscitated patients. Myocardial revascularization techniques increase postresuscitation survival duration more than 1 year.
ThT11 :W31 ] Nutrition and hypertension M. Boshtam, M. Rafiei, A. Jalali, N. Sarraf-Zadegan, EA. Sayed-Tabatabaei. Isfahan Cardiovascular Research Center, lsfahan, lran
Objective: Hypertension considered as a major risk factor for coronary artery disease (CAD). As the CAD is the a major cause of death in Isfahan (Iran), and also Isfahan Salt Study couldn't show any relationship between blood pressure and salt, we decided to investigate the relation between dietary habit and blood pressure. Methods: The analyses conducted on the data of the 2nd ICVDRF Survey. The sample size for this study was 1200 men and women selected from Isfahan population. Dietary intakes were estimated using 24-hr record-assisted recall for 3 days by FCP-HC software. Also for each subject, inquired information was obtained by a standard questionnaire. A fasting blood specimen for the analyses of serum lipids was taken from each one. Blood pressures of all subjects were measured according to WHO criteria from right ann in sitting position after at least 5 minutes of rest. All people who are on a diet were excluded from the analysis. Results: The table presents the difference between the mean values of some nutrients between hypertensive and normotensive subjects. Logistic regression showed only the relation between hypertension and dietary cholesterol intake after adjustment for age, sex, occupation, serum lipids and smoking (OR = 0.99, p = 0.01). Conclusion: Although the intakes of all nutrients were significantly more
Objective: The benefits of cardiac rehabilitation programs on improving exercise capacity and body mass index were reported previously. This study assesses the relative benefits of cardiac rehabilitation program in women compared to men. Methods: We compared the results of cardiac rehabilitation in 27 women (age 54 4- 8.21 years) with 99 men (age 51.84 4- 9.58 year). All patients completed a rehabilitation program of 24 sessions, each 60 minutes (three sessions weekly). Results: Following the cardiac rehabilitation and exercise training program, women had significant improvements inexercise capacity (42%, P < 0.000) and body mass index (-3.6%, P < 0.001). For parameters, improvements following the cardiac rehabilitation program were statistically similar in women and men. Conclusions: We believe these data further support the idea that women should be routinely referred for cardiac rehabiliation programs following major CAD events. 1
ThT13:W31 ] Comparing the efficacy of statins in various patient
subgroups in the atorvastatin comparative cholesterol efficacy and safety study (ACCESS) V.M. Campese I , J.B. Kostis2, C.L. Shear3. For the ACCESS Investigators; I LAC,q.]SC Medical Center, Los Angeles, CA; 2 UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ; 3Pfizer Central Research, Groton, CT, USA
Background: Data consistently show that many patients do not reach National Cholesterol Education Program (NCEP) LDL-C goals. ACCESS study subanalyses compared statin efficacy in various patient populations including women, patients > 70 years and African-Americans. Methods: Patients (n = 3916) meeting NCEP drug treatment criteria were randomized to atorvastatin (10-80 mg), simvastatin (10--40 mg), pravastatin (10--40 mg), fluvastatin (20-80 mg) or lovastatin (20-80 mg). Patients were randomized in a 4 to 1 ratio (atorva, n = 1958; simva, n = 482; prava, n = 481; fiuva, n = 497; lova, n = 498) and received initial doses for 6 weeks. Thereafter, patients were titrated if they did not reach NCEP LDL-C goals and were followed to 54 weeks. Results: At Week 6, reductions from baseline in LDL-C, TC and TG were significantly greater with atorvastatin 10 mg compared with other statins at their initial doses for women and patients > 70 years (all p < 0.05). This was also true for African-Americans (with the exception of TG levels vs pravastatin). Proportions of patients reaching NCEP goals are given below. Patient subgroup (*p < 0.05 vs atorva) Women Patients > 70 years African-Americans
Atorva 57.2 54.8 41.9
%of patientsreachingNCEPgoalat Week6 Simva Prava Lova 42.5* 20.2* 28.0* 39.3* 16.8' 36.1 32.1 20.8* 16.0*
Fluva 20.2* 17.2* 11.1*
All statins were well tolerated and produced comparable adverse event rates. Conclusion: In the patient subgroups studied, a significantly greater proportion of atorvastatin-treated patients achieved NCEP goals at starting dose compared with patients treated with other statins.
Xllth International Symposium on Atherosclerosis, Stockholm, Sweden, June 25-29, 2000
315
Hypertensives Mean 4- SD
Normotensives Mean 4- SD
95% CI
P
Nutrients Energy (Kcal) Protein (gr) Carbohydrate (gr) Cholesterol (mg) Fat (gr) SFA (gr) MUFA (gr) PUFA (gr)
2251.6 4- 982.3 76.9 + 29.2 327.5 4- 123.0 225.8 4- 158.4 71.9 4- 65.5 32.6 4- 38.4 23.2 4- 20.5 12.34 4- 10.2
2522.6 4- 1271.5 82.3 4- 3 3 3 362.3 4- 225.7 273.1 4- 190.4 83.6 4- 47.6 37.3 4- 21.9 26.8 4- 15.0 15.2 4- 13.5
117.1,424.8 1.28, 9.6 9.02, 60.6 25.4, 69.3 4.7, 18.6 1.07, 8.36 1.43, 5.82 1.42, 4.4
0.00l 0.01 0.008 0.000 0.001 0.011 0.001 0.000
in hypertensives than normotensives but only cholesterol intake can be a contributor dietary factors for hypertension in Iranian population.
ThT12:W31 ] Effets of cardiac rehabilitation and exercise training on
exercise capacity and body mass index in women K. Rabiei, J. Najafian. Isfahan Cardiovascular Research Center, lsfahan, /ran
3
ThT10:W31 ] Cardiovascular risk factors analysis in patients with
sudden death after acute myocardial infarction Gabriela Ciobotaru, D. Burghina, Deliana Vasiluta, R. Popa, Minodora Mihalas, Anca Isac, Oana Tunea, C. Domide, I.A. Rivis. 1st Internal Medicine Clinic - City Hospital Timisoara, Romania The present work aimed to correlate the risk factors in acute myocardial infarction (AMI) patients and their role in appearance and control of sudden death. Material and Method: We studied 174 patients with AMI, which presented sudden death, hospitalized between 1995-1999. There was analyzed: the existence of the risk factors with predictive value for the sudden death, the heart hypertrophy - dilatation, EKG aspects. Results: 31.5% from the patients were successfully resuscitated after ventricular fibrillation (20 patients) and after ventricular tachycardia (4 patients). The location of AMI in surviving patients was 50% inferior, 37.5% anterior, 12.5% non-Q. The average age was 54.5 in surviving patients and 66.1% in deceaseds. The risk factors for the unsuccessfully resuscitation were: male (Odds Ratio: OR = 1.12, and Relative Risk: RR = 1.03); age over 60 years (OR = 10.4 and RR = 3.92); the anterior location of AMI as compared to inferior location (OR = 36, RR = 4.88); the presence of hypertrophied-dilated heart (OR = 2.24, RR = 1.29). Patients invasive treated (PTCA, stent or CABG) and their rate of survival at 1 year was 75% as compared to 41.6% in patients medical treated. The rate of survival was less than 6 month in patients with dilated heart. Conclusions: Risk factors synergy increases the sudden death risk in young persons, males, aged over 60, anterior location of AMI. Cardiac dilation reduced postresuscitation survival less than 3 month. Ventricular fibrillation was the main mechanism of sudden death in resuscitated patients. Myocardial revascularization techniques increase postresuscitation survival duration more than 1 year.
ThT11 :W31 ] Nutrition and hypertension M. Boshtam, M. Rafiei, A. Jalali, N. Sarraf-Zadegan, EA. Sayed-Tabatabaei. Isfahan Cardiovascular Research Center, lsfahan, lran
Objective: Hypertension considered as a major risk factor for coronary artery disease (CAD). As the CAD is the a major cause of death in Isfahan (Iran), and also Isfahan Salt Study couldn't show any relationship between blood pressure and salt, we decided to investigate the relation between dietary habit and blood pressure. Methods: The analyses conducted on the data of the 2nd ICVDRF Survey. The sample size for this study was 1200 men and women selected from Isfahan population. Dietary intakes were estimated using 24-hr record-assisted recall for 3 days by FCP-HC software. Also for each subject, inquired information was obtained by a standard questionnaire. A fasting blood specimen for the analyses of serum lipids was taken from each one. Blood pressures of all subjects were measured according to WHO criteria from right ann in sitting position after at least 5 minutes of rest. All people who are on a diet were excluded from the analysis. Results: The table presents the difference between the mean values of some nutrients between hypertensive and normotensive subjects. Logistic regression showed only the relation between hypertension and dietary cholesterol intake after adjustment for age, sex, occupation, serum lipids and smoking (OR = 0.99, p = 0.01). Conclusion: Although the intakes of all nutrients were significantly more
Objective: The benefits of cardiac rehabilitation programs on improving exercise capacity and body mass index were reported previously. This study assesses the relative benefits of cardiac rehabilitation program in women compared to men. Methods: We compared the results of cardiac rehabilitation in 27 women (age 54 4- 8.21 years) with 99 men (age 51.84 4- 9.58 year). All patients completed a rehabilitation program of 24 sessions, each 60 minutes (three sessions weekly). Results: Following the cardiac rehabilitation and exercise training program, women had significant improvements inexercise capacity (42%, P < 0.000) and body mass index (-3.6%, P < 0.001). For parameters, improvements following the cardiac rehabilitation program were statistically similar in women and men. Conclusions: We believe these data further support the idea that women should be routinely referred for cardiac rehabiliation programs following major CAD events. 1
ThT13:W31 ] Comparing the efficacy of statins in various patient
subgroups in the atorvastatin comparative cholesterol efficacy and safety study (ACCESS) V.M. Campese I , J.B. Kostis2, C.L. Shear3. For the ACCESS Investigators; I LAC,q.]SC Medical Center, Los Angeles, CA; 2 UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ; 3Pfizer Central Research, Groton, CT, USA
Background: Data consistently show that many patients do not reach National Cholesterol Education Program (NCEP) LDL-C goals. ACCESS study subanalyses compared statin efficacy in various patient populations including women, patients > 70 years and African-Americans. Methods: Patients (n = 3916) meeting NCEP drug treatment criteria were randomized to atorvastatin (10-80 mg), simvastatin (10--40 mg), pravastatin (10--40 mg), fluvastatin (20-80 mg) or lovastatin (20-80 mg). Patients were randomized in a 4 to 1 ratio (atorva, n = 1958; simva, n = 482; prava, n = 481; fiuva, n = 497; lova, n = 498) and received initial doses for 6 weeks. Thereafter, patients were titrated if they did not reach NCEP LDL-C goals and were followed to 54 weeks. Results: At Week 6, reductions from baseline in LDL-C, TC and TG were significantly greater with atorvastatin 10 mg compared with other statins at their initial doses for women and patients > 70 years (all p < 0.05). This was also true for African-Americans (with the exception of TG levels vs pravastatin). Proportions of patients reaching NCEP goals are given below. Patient subgroup (*p < 0.05 vs atorva) Women Patients > 70 years African-Americans
Atorva 57.2 54.8 41.9
%of patientsreachingNCEPgoalat Week6 Simva Prava Lova 42.5* 20.2* 28.0* 39.3* 16.8' 36.1 32.1 20.8* 16.0*
Fluva 20.2* 17.2* 11.1*
All statins were well tolerated and produced comparable adverse event rates. Conclusion: In the patient subgroups studied, a significantly greater proportion of atorvastatin-treated patients achieved NCEP goals at starting dose compared with patients treated with other statins.
Xllth International Symposium on Atherosclerosis, Stockholm, Sweden, June 25-29, 2000