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- Kotseva, K, et al.
(författare)
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Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry
- 2019
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Ingår i: European journal of preventive cardiology. - : Oxford University Press (OUP). - 2047-4881 .- 2047-4873. ; 26:8, s. 824-835
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%. Conclusion A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.
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- O'Flaherty, M., et al.
(författare)
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Exploring potential mortality reductions in 9 European countries by improving diet and lifestyle: A modelling approach
- 2016
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 207, s. 286-291
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Tidskriftsartikel (refereegranskat)abstract
- Background: Coronary heart disease (CHD) death rates have fallen across most of Europe in recent decades. However, substantial risk factor reductions have not been achieved across all Europe. Our aim was to quantify the potential impact of future policy scenarios on diet and lifestyle on CHD mortality in 9 European countries. Methods: We updated the previously validated IMPACT CHD models in 9 European countries and extended them to 2010-11 (the baseline year) to predict reductions in CHD mortality to 2020(ages 25-74 years). We compared three scenarios: conservative, intermediate and optimistic on smoking prevalence (absolute decreases of 5%, 10% and 15%); saturated fat intake (1%, 2% and 3% absolute decreases in % energy intake, replaced by unsaturated fats); salt (relative decreases of 10%, 20% and 30%), and physical inactivity (absolute decreases of 5%, 10% and 15%). Probabilistic sensitivity analyses were conducted. Results: Under the conservative, intermediate and optimistic scenarios, we estimated 10.8% (95% CI: 7.3-14.0), 20.7% (95% CI: 15.6-25.2) and 29.1% (95% CI: 22.6-35.0) fewer CHD deaths in 2020. For the optimistic scenario, 15% absolute reductions in smoking could decrease CHD deaths by 8.9%-11.6%, Salt intake relative reductions of 30% by approximately 5.9-8.9%; 3% reductions in saturated fat intake by 6.3-7.5%, and 15% absolute increases in physical activity by 3.7-5.3%. Conclusions: Modest and feasible policy-based reductions in cardiovascular risk factors (already been achieved in some other countries) could translate into substantial reductions in future CHD deaths across Europe. However, this would require the European Union to more effectively implement powerful evidence-based prevention policies. (C) 2016 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY license.
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- Abirifard, Mahmoud, et al.
(författare)
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Jahani Salt Diapir, Iran : hydrogeology, karst features and effect on surroundings environment
- 2017
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Ingår i: International Journal of Speleology. - 0392-6672 .- 1827-806X. ; 46:3, s. 445-457
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Tidskriftsartikel (refereegranskat)abstract
- The Jahani Salt Diapir (JSD), with an area of 54 km(2), is an active diapir in the Simply Folded Belt of the Zagros Orogeny, in the south of Iran. Most of the available studies on this diapir are focused on tectonics. The hydrogeology, schematic model of flow direction and hydrochemical effects of the JSD on the adjacent water resources are lacking, and thus, are the focus of this study. The morphology of the JSD was reevaluated by fieldwork and using available maps. The physicochemical characteristics of the springs and hydrometric stations were also measured. The vent of the diapir is located 250 m higher than the surrounding glaciers, and covered by small polygonal sinkholes (dolines). The glacier is covered by cap soils, sparse trees and pastures, and contains large sinkholes, numerous shafts, several caves, and 30 brine springs. Two main groups of caves were distinguished. Sub-horizontal or inclined stream passages following the surface valleys and vertical shafts (with short inlet caves) at the bottoms of nearly circular blind valleys. Salt exposure is limited to steep slopes. The controlling variables of flow route within salt diapirs are the negligible porosity of the salt rocks at depth more than about ten meters below the ground surface and the rapid halite saturation along the flow route. These mechanisms prevent deep cave development and enforce the emergence points of brine springs with low flow rates and small catchment area throughout the JSD and above the local base of erosion. Tectonics do not affect karst development, because the distributions of sinkholes and brine springs show no preferential directions. The type of spring water is sodium chloride, with a TDS of 320 g/l, and saturated with halite, gypsum, calcite and dolomite. The water balance budget of the JSD indicates that the total recharge water is 1.46 MCM (million cubic meter)/a, emerges from 30 brine springs, two springs from the adjacent karstic limestone, and flows into the Firoozabad River (FR) and the adjacent alluvium aquifer. The FR cuts through the northern margin of the salt diapir, dissolving the glacier salts at the contact with JSD, increasing the halite concentration of the 17.7 MCM/a of the FR from 100 mg/l to 12,000 mg/l. This is a permanent process because the active glacier flows rapidly down the steep slopes into the river gorge from the nearby vent. The possible relocation of the FR channel would enhance the FR water quality, but disrupt the natural beauty of the diapir.
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