| 1. |
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| 2. |
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| 3. |
- Borghi, Claudio, et al.
(författare)
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Serum uric acid levels are associated with cardiovascular risk score : A post hoc analysis of the EURIKA study
- 2018
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Ingår i: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 253, s. 167-173
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reports are conflicting on whether serum uric acid (sUA) levels are independently associated with increased cardiovascular (CV) death risk. Methods: This post hoc analysis assessed the relationship between sUA levels and CV death risk score in 7531 patients from the cross-sectional, multinational EURIKA study (NCT00882336). Patients had at least one CV risk factor but no clinical CV disease. Ten-year risk of CV death was estimated using SCORE-HDL and SCORE algorithms, categorized as low (<1%), intermediate (1% to <5%), high (>5% to <10%) or very high (>10%). Results: Mean serum sUA levels increased significantly with increasing CV death risk category in the overall population and in subgroups stratified by diuretics use or renal function (all P < 0.0001). Multivariate ordinal logistic regression analyses, adjusted for factors significantly associated with CV death risk in univariate analyses (study country, body mass index, number of CV risk factors and comorbidities, use of lipid lowering therapies, antihypertensives and antidiabetics), showed a significant association between sUA levels and SCORE-HDL category in the overall population (OR: 1.39 [95% CI: 1.34-1.44]) and all subgroups (using diuretics: 1.32 [1.24-1.40]; not using diuretics: 1.46 [1.39-1.53]; estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73 m(2): 1.30 [1.22-1.38]; eGFR >= 60 ml/min/1.73 m(2): 1.44 [1.38-1.51]; all P < 0.0001). Similar results were obtained when using SCORE. Conclusions: Higher sUA levels are associated with progressively higher 10-year CV death risk score in patients with at least one CV risk factor but no CV disease. (c) 2017 Elsevier B.V. All rights reserved.
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| 4. |
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| 5. |
- Dallongeville, Jean, et al.
(författare)
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Survey of physicians' practices in the control of cardiovascular risk factors : the EURIKA study.
- 2012
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Ingår i: European journal of preventive cardiology. - : Oxford University Press (OUP). - 2047-4881 .- 2047-4873. ; 19:3, s. 541-550
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess the practices of physicians in 12 European countries in the primary prevention of cardiovascular disease (CVD).METHODS: In 2009, 806 physicians from 12 European countries answered a questionnaire, delivered electronically or by post, regarding their assessment of patients with cardiovascular risk factors, and their use of risk calculation tools and clinical practice guidelines (ClinicalTrials.gov number: NCT00882336). Approximately 60 physicians per country were selected (participation rate varied between 3.1% in Sweden and 22.8% in Turkey).RESULTS: Among participating physicians, 85.2% reported using at least one clinical guideline for CVD prevention. The most popular were the ESC guidelines (55.1%). Reasons for not using guidelines included: the wide choice available (47.1%), time constraints (33.3%), lack of awareness of guidelines (27.5%), and perception that guidelines are unrealistic (23.5%). Among all physicians, 68.5% reported using global risk calculation tools. Written charts were the preferred method (69.4%) and the most commonly used was the SCORE equation (35.4%). Reasons for not using equations included time constraints (59.8%), not being convinced of their usefulness (21.7%) and lack of awareness (19.7%). Most physicians (70.8%) believed that global risk-equations have limitations; 89.8% that equations overlook important risk factors, and 66.5% that they could not be used in elderly patients. Only 46.4% of physicians stated that their local healthcare framework was sufficient for primary prevention of CVD, while 67.2% stated that it was sufficient for secondary prevention of CVD.CONCLUSIONS: A high proportion of physicians reported using clinical guidelines for primary CVD prevention. However, time constraints, lack of perceived usefulness and inadequate knowledge were common reasons for not using CVD prevention guidelines or global CVD risk assessment tools.
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| 6. |
- De Backer, Guy, et al.
(författare)
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A short history of the European Association of Preventive Cardiology (EAPC)
- 2022
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press. - 2047-4873 .- 2047-4881. ; 29:9, s. 1301-1308
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The EAPC is now fit to address future challenges with a unified organization and strong multidisciplinary leadership together with the EJPC, the annual ESC Preventive Cardiology Congress, strong representation of preventive cardiology in the annual ESC Congresses, the ESC Textbook and Handbook of Preventive Cardiology, postgraduate educational activities, position papers and involvement in guidelines related to all aspects of preventive cardiology together with accreditations and a core curriculum for preventive cardiology as major assets under a common brand addressing primordial, primary, and secondary prevention of CVD.
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| 7. |
- Eliasson, Mats, et al.
(författare)
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Nya SCORE bättre på att skatta risk för död i hjärtinfarkt och stroke : Viktigt att riskmodeller rekalibreras och implementeras i den kliniska vardagen
- 2017
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Ingår i: Läkartidningen. - : Läkartidningen förlag. - 0023-7205 .- 1652-7518. ; 114:15/16
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Att skatta risk för kardiovaskulär sjukdom är ett viktigt redskap i primärpreventivt arbete och ger stöd för råd om ändrade levnadsvanor och ställningstagande till läkemedelsbehandling för hypertoni eller höga kolesterolvärden. En ny version av SCORE baserad på aktuella svenska data har nyligen publicerats och visar god förmåga att skatta risk att dö i stroke eller infarkt inom 10 år. Få personer i åldrarna 40–65 år har hög risk men desto fler har fortfarande en måttlig risk. SCORE 2015 kan användas vid konsultationer om kardiovaskulär risk.
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| 8. |
- Guallar, Eliseo, et al.
(författare)
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Excess risk attributable to traditional cardiovascular risk factors in clinical practice settings across Europe : The EURIKA Study
- 2011
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 18:11
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPhysicians involved in primary prevention are key players in CVD risk control strategies, but the expected reduction in CVD risk that would be obtained if all patients attending primary care had their risk factors controlled according to current guidelines is unknown. The objective of this study was to estimate the excess risk attributable, firstly, to the presence of CVD risk factors and, secondly, to the lack of control of these risk factors in primary prevention care across Europe.MethodsCross-sectional study using data from the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA), which involved primary care and outpatient clinics involved in primary prevention from 12 European countries between May 2009 and January 2010. We enrolled 7,434 patients over 50 years old with at least one cardiovascular risk factor but without CVD and calculated their 10-year risk of CVD death according to the SCORE equation, modified to take diabetes risk into account.ResultsThe average 10-year risk of CVD death in study participants (N = 7,434) was 8.2%. Hypertension, hyperlipidemia, smoking, and diabetes were responsible for 32.7 (95% confidence interval 32.0-33.4), 15.1 (14.8-15.4), 10.4 (9.9-11.0), and 16.4% (15.6-17.2) of CVD risk, respectively. The four risk factors accounted for 57.7% (57.0-58.4) of CVD risk, representing a 10-year excess risk of CVD death of 5.66% (5.47-5.85). Lack of control of hypertension, hyperlipidemia, smoking, and diabetes were responsible for 8.8 (8.3-9.3), 10.6 (10.3-10.9), 10.4 (9.9-11.0), and 3.1% (2.8-3.4) of CVD risk, respectively. Lack of control of the four risk factors accounted for 29.2% (28.5-29.8) of CVD risk, representing a 10-year excess risk of CVD death of 3.12% (2.97-3.27).ConclusionsLack of control of CVD risk factors was responsible for almost 30% of the risk of CVD death among patients participating in the EURIKA Study.
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| 9. |
- Halcox, Julian P., et al.
(författare)
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Prevalence and treatment of atherogenic dyslipidemia in the primary prevention of cardiovascular disease in Europe : EURIKA, a cross-sectional observational study
- 2017
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Ingår i: BMC Cardiovascular Disorders. - : BioMed Central. - 1471-2261 .- 1471-2261. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Atherogenic dyslipidemia is associated with poor cardiovascular outcomes, yet markers of this condition are often ignored in clinical practice. Here, we address a clear evidence gap by assessing the prevalence and treatment of two markers of atherogenic dyslipidemia: elevated triglyceride levels and low levels of high-density lipoprotein cholesterol. Methods: This cross-sectional observational study assessed the prevalence of two atherogenic dyslipidemia markers, high triglyceride levels and low high-density lipoprotein cholesterol levels, in the study population from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; N = 7641; of whom 51.6% were female and 95.6% were White/Caucasian). The EURIKA population included European patients, aged at least 50 years with at least one cardiovascular risk factor but no history of cardiovascular disease. Results: Over 20% of patients from the EURIKA population have either triglyceride or high-density lipoprotein cholesterol levels characteristic of atherogenic dyslipidemia. Furthermore, the proportions of patients with one of these markers were higher in subpopulations with type 2 diabetes mellitus or those already calculated to be at high risk of cardiovascular disease. Approximately 55% of the EURIKA population who have markers of atherogenic dyslipidemia are not receiving lipid-lowering therapy. Conclusions: A considerable proportion of patients with at least one major cardiovascular risk factor in the primary cardiovascular disease prevention setting have markers of atherogenic dyslipidemia. The majority of these patients are not receiving optimal treatment, as specified in international guidelines, and thus their risk of developing cardiovascular disease is possibly underestimated.
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| 13. |
- Kristiansen, Oscar, et al.
(författare)
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Effect of atorvastatin on muscle symptoms in coronary heart disease patients with self-perceived statin muscle side-effects : a randomized, double-blinded crossover trial
- 2021
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Ingår i: European Heart Journal - Cardiovascular Pharmacotherapy. - : Oxford University Press. - 2055-6837 .- 2055-6845. ; 7:6, s. 507-516
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To estimate the effect of atorvastatin on muscle symptom intensity in coronary heart disease (CHD) patients with self-perceived statin-associated muscle symptoms (SAMS) and to determine the relationship to blood levels of atorvastatin and/or metabolites.METHODS AND RESULTS: A randomized multi-center trial consecutively identified 982 patients with previous or ongoing atorvastatin treatment after a CHD event. Of these, 97 (9.9%) reported SAMS and 77 were randomized to 7-weeks double-blinded treatment with atorvastatin 40 mg/day and placebo in a crossover design. The primary outcome was the individual mean difference in muscle symptom intensity between the treatment periods, measured by visual-analogue scale (VAS) scores. Atorvastatin did not affect the intensity of muscle symptoms among 71 patients who completed the trial. Mean VAS difference [statin-placebo] was 0.31 (95% CI -0.24-0.86). The proportion with more muscle symptoms during placebo than atorvastatin was 17% (n = 12), 55% (n = 39) had the same muscle symptom intensity during both treatment periods whereas 28% (n = 20) had more symptoms during atorvastatin than placebo (confirmed SAMS). There were no differences in clinical or pharmacogenetic characteristics between these groups. The levels of atorvastatin and/or metabolites did not correlate to muscle symptom intensity among patients with confirmed SAMS (Spearmans rho ≤0.40, for all variables).CONCLUSION: Re-challenge with high-intensity atorvastatin did not affect the intensity of muscle symptoms in CHD patients with self-perceived SAMS during previous atorvastatin therapy. There was no relationship between muscle symptoms and the systemic exposure to atorvastatin and/or its metabolites. The findings encourage an informed discussion to elucidate other causes of muscle complaints and continued statin use.
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| 14. |
- Kristiansen, Oscar, et al.
(författare)
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The relationship between directly measured statin adherence, self-reported adherence measures and cholesterol levels in patients with coronary heart disease
- 2021
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Ingår i: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484. ; 336, s. 23-29
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: We aimed to determine the relationship between statin adherence measured directly, and by self-report measures and serum cholesterol levels.METHODS: Patients prescribed atorvastatin (N = 373) participated in a cross-sectional study 2-36 months after a coronary event. Self-reported adherence included statin adherence the past week, the 8-item Morisky medication adherence scale (MMAS-8), and the Gehi et al. adherence question. Atorvastatin was measured directly in spot blood plasma by a novel liquid chromatography tandem mass-spectrometry method discriminating adherence (0-1 doses omitted) and reduced adherence (≥2 doses omitted). Participants were unaware of the atorvastatin analyses at study participation.RESULTS: Mean age was 63 (SD 9) years and 8% had reduced atorvastatin adherence according to the direct method. In patients classified with reduced adherence by the direct method, 40% reported reduced statin adherence, 32% reported reduced adherence with the MMAS-8 and 22% with the Gehi question. In those adherent by the direct method, 96% also reported high statin adherence, 95% reported high adherence on the MMAS-8 whereas 94% reported high adherence on the Gehi question. Cohen's kappa agreement score with the direct method was 0.4 for self-reported statin adherence, 0.3 for the Gehi question and 0.2 for the MMAS-8. Adherence determined by the direct method, self-reported statin adherence last week, and the Gehi question was inversely related to LDL-cholesterol levels with a p-value of <0.001, 0.001 and 0.004, respectively.CONCLUSIONS: Plasma-statin measurements reveal reduced adherence with higher sensitivity than self-report measures, relate to cholesterol levels, and may prove to be a useful tool to improve lipid management.
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| 15. |
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| 16. |
- Munkhaugen, John, et al.
(författare)
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Managing patients with prediabetes and type 2 diabetes after coronary events : individual tailoring needed - a cross-sectional study
- 2018
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Ingår i: BMC Cardiovascular Disorders. - : BioMed Central. - 1471-2261 .- 1471-2261. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Understanding the determinants associated with prediabetes and type 2 diabetes in coronary patients may help to individualize treatment and modelling interventions. We sought to identify sociodemographic, medical and psychosocial factors associated with normal blood glucose (HbA1c < 5.7%), prediabetes (HbA1c 5.7-6.4%), and type 2 diabetes. Methods: A cross-sectional explorative study applied regression analyses to investigate the factors associated with glycaemic status and control (HbA1c level) in 1083 patients with myocardial infarction and/or a coronary revascularization procedure. Data were collected from hospital records at the index event and from a self-report questionnaire and clinical examination with blood samples at 2-36 months follow-up. Results: In all, 23% had type 2 diabetes, 44% had prediabetes, and 33% had normal blood glucose at follow-up. In adjusted analyses, type 2 diabetes was associated with larger waist circumference (Odds Ratio 1.03 per 1.0 cm, p = 0.001), hypertension (Odds Ratio 2.7, p < 0.001), lower high-density lipoprotein cholesterol (Odds Ratio 0.3 per1.0 mmol/L, p = 0. 002) and insomnia (Odds Ratio 2.0, p= 0.002). In adjusted analyses, prediabetes was associated with smoking (Odds Ratio 33, p = 0.001), hypertension (Odds Ratio 1.5, p = 0.03), and non-participation in cardiac rehabilitation (Odds Ratio 1.7, p = 0. 003). In patients with type 2 diabetes, a higher HbA(1c) level was associated with ethnic minority background (standardized beta [beta] 0.19, p = 0.005) and low drug adherence (0 0.17, p = 0.01). In patients with prediabetes or normal blood glucose, a higher HbA(1c) was associated with larger waist circumference (beta 0.13, p < 0.001), smoking (beta 0.18, p < 0.001), hypertension (beta 0.08, p = 0.04), older age (beta 0.16, p < 0.001), and non-participation in cardiac rehabilitation (beta 0.11, p = 0.005). Conclusions: Along with obesity and hypertension, insomnia and low drug adherence were the major modifiable factors associated with type 2 diabetes, whereas smoking and non-participation in cardiac rehabilitation were the factors associated with prediabetes. Further research on the effect of individual tailoring, addressing the reported significant predictors of failure, is needed to improve glycaemic control.
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| 17. |
- Munkhaugen, John, et al.
(författare)
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Medical and psychosocial factors and unfavourable low-density lipoprotein cholesterol control in coronary patients
- 2017
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Ingår i: European Journal of Preventive Cardiology. - : Sage Publications. - 2047-4873 .- 2047-4881. ; 24:9, s. 981-989
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Tidskriftsartikel (refereegranskat)abstract
- Objective Understanding the determinants of low-density lipoprotein cholesterol (LDL-C) control constitutes the basis of modelling interventions for optimal lipid control and prognosis. We aim to identify medical and psychosocial (study) factors associated with unfavourable LDL-C control in coronary patients. Methods A cross-sectional explorative study used logistic and linear regression analysis to investigate the association between study factors and LDL-C in 1095 patients, hospitalized with myocardial infarction and/or a coronary revascularization procedure. Data were collected from hospital records, a comprehensive self-report questionnaire, clinical examination and blood samples after 2-36 months follow-up. Results Fifty-seven per cent did not reach the LDL-C target of 1.8 mmol/l at follow-up. Low socioeconomic status and psychosocial factors were not associated with failure to reach the LDL-C target. Statin specific side-effects (odds ratio 3.23), low statin adherence (odds ratio 3.07), coronary artery by-pass graft operation as index treatment (odds ratio 1.95), ≥ 1 coronary event prior to the index event (odds ratio 1.81), female gender (odds ratio 1.80), moderate- or low-intensity statin therapy (odds ratio 1.62) and eating fish < 3 times/week (odds ratio 1.56) were statistically significantly associated with failure to reach the LDL-C target, in adjusted analyses. Only side-effects (standardized β 0.180), low statin adherence (β 0.209) and moderate- or low-intensity statin therapy (β 0.228) were associated with LDL-C in continuous analyses. Conclusions Statin specific side-effects, low statin adherence and moderate- or low-intensity statin therapy were the major factors associated with unfavourable LDL-C control. Interventions to improve LDL-C should ensure adherence and prescription of sufficiently potent statins, and address side-effects appropriately. © European Society of Cardiology 2017.
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| 18. |
- Munkhaugen, John, et al.
(författare)
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Statin-associated muscle symptoms in coronary patients : design of a randomized study
- 2019
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Ingår i: Scandinavian Cardiovascular Journal. - : Taylor & Francis Group. - 1401-7431 .- 1651-2006. ; 53:3, s. 162-168
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Estimate the effect of atorvastatin on muscular symptom intensity in coronary patients with subjective statin-associated muscle symptoms (SAMS) and to determine the association with blood levels of atorvastatin and its metabolites, to obtain an objective marker for true SAMS. Design. A randomized, double-blinded, cross-over study will include 80 coronary patients with subjectively reported SAMS during ongoing atorvastatin therapy or previous muscle symptoms that led to discontinuation of atorvastatin. Patients will be randomized to 7-weeks treatment with atorvastatin 40mg/day in the first period and matched placebo in the second 7-weeks period, or placebo in the first period and atorvastatin in the second period. Each period is preceded by 1-week wash-out. A control group (n=40) without muscle symptoms will have 7 weeks open treatment with atorvastatin 40mg/day. Blood samples will be collected at baseline and at the end of each treatment period, and muscular symptoms will be rated by the patients weekly using a Visual Analogue Scale (VAS). The primary outcome is the difference in aggregated mean VAS scores between the last three weeks of atorvastatin treatment and of placebo treatment. The main purpose is to develop an objective marker for true SAMS, by comparing SAMS associated with blinded atorvastatin treatment with blood concentrations of atorvastatin and its metabolites. Diagnostic and discrimination performance will be determined. Conclusions. The study provides new knowledge on SAMS in coronary patients and may contribute to more personalized statin treatment and monitoring, fewer side-effects and consequently improved adherence and lipid management in future practice.
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| 19. |
- Peersen, Kari, et al.
(författare)
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Clinical and psychological factors in coronary heart disease patients with statin associated muscle side-effects
- 2021
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Ingår i: BMC Cardiovascular Disorders. - : BioMed Central. - 1471-2261 .- 1471-2261. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTo compare clinical and psychological factors among patients with self-perceived statin-associated muscle symptoms (SAMS), confirmed SAMS, and refuted SAMS in coronary heart disease patients (CHD).MethodsData were obtained from a cross-sectional study of 1100 CHD outpatients and a study of 71 CHD outpatients attending a randomized, double-blinded, placebo-controlled, crossover study to test effects of atorvastatin 40 mg/day on muscle symptom intensity. Clinical and psychosocial factors were compared between patients with and without SAMS in the cross-sectional study, and between patients with confirmed SAMS and refuted SAMS in the randomized study.ResultsBilateral, symmetric muscle symptoms in the lower extremities during statin treatment were more prevalent in patients with confirmed SAMS compared to patients with refuted SAMS (75% vs. 41%, p = 0.01) in the randomized study. No significant differences in psychological factors (anxiety, depression, worry, insomnia, type D personality characteristics) were detected between patients with and without self-perceived SAMS in the cross-sectional study, or between patients with confirmed SAMS and refuted SAMS, in the randomized study.ConclusionsPatients with confirmed SAMS more often present with bilateral lower muscle symptoms compared to those with refuted SAMS. Psychological factors were not associated with self-perceived SAMS or confirmed SAMS. A careful pain history and a search for alternative causes of muscle symptoms are likely to promote communication in patients with SAMS, and may reduce the risk for statin discontinuation.
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| 20. |
- Peersen, Kari, et al.
(författare)
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Medical and Psychosocial Factors Associated With Low Physical Activity and Increasing Exercise Level After a Coronary Event
- 2020
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Ingår i: Journal of Cardiopulmanory Rehabilitation and Prevention (JCRP). - : Lippincott Williams & Wilkins. - 1932-7501 .- 1932-751X. ; 40:1, s. 35-40
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The reasons why many coronary patients are inactive or have a low level of physical activity (PA) are not completely understood. We identified medical and psychosocial factors associated with PA status and increasing exercise level after a coronary event. Methods: A cross-sectional study investigated the factors associated with PA in 1101 patients hospitalized with myocardial infarction (MI) and/or a revascularization procedure. Data were collected from hospital records, a self-report questionnaire, and a clinical examination. PA was categorized as inactivity, low activity, and adequate activity (>= moderate intensity of 30 min >= 2-3 times/wk), an overall summary PA-index was measured as a continuous variable, and self-reported PA increase since the index event was measured on a 0- to 10-point Likert Scale. Results: In all, 18% reported inactivity, 42% low, and 40% adequate activity at follow-up after median 16 mo. In multiadjusted linear regression analyses, low PA-index was significantly associated with smoking, obesity, unhealthy diet, depression, female, low education, MI as index diagnosis, and >= 1 previous coronary event. Motivation, risk and illness perceptions, and low reported need of help to increase PA were significantly associated with self-reported increasing PA level in adjusted continuous analyses. Conclusions: Daily smoking, obesity, unhealthy diet, and depression were the major potentially modifiable factors associated with insufficient PA, whereas high motivation and risk and illness perceptions were associated with increasing PA level. Further research on the effect of interventions tailored to the reported significant factors of failure is needed to improve PA level in CHD patients.
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| 21. |
- Peersen, Kari, et al.
(författare)
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The role of cardiac rehabilitation in secondary prevention after coronary events
- 2017
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Ingår i: European Journal of Preventive Cardiology. - : Sage Publications. - 2047-4873 .- 2047-4881. ; 24:13, s. 1360-1368
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Tidskriftsartikel (refereegranskat)abstract
- Background Coronary risk factor control in Europe is suboptimal and there are large variations in the nature of cardiac rehabilitation (CR) programmes offered to coronary heart disease patients. We aim to explore characteristics and risk factor control in patients recruited from two neighbouring hospitals offering CR with different content. Methods In a cross-sectional study, 1127 Norwegian patients hospitalized with acute myocardial infarction and/or a revascularization procedure attended a clinical visit and completed a questionnaire at 2-36 months' follow-up. The hospital of Vestfold provides comprehensive CR, while the hospital of Drammen provides mainly exercise-based CR. Results At follow-up, patients in Vestfold performed more physical activity (p=0.02), were less obese (p=0.02) and reported better medication adherence (p=0.02) than patients in Drammen. The perceived need for information and follow-up was higher in Drammen than Vestfold (p<0.001). The CR participation rate in Vestfold was 75% compared with 18% in Drammen. CR participation in Vestfold was associated with higher prevalence of smoking cessation (p=0.001), lower low-density lipoprotein cholesterol (p=0.01) and better medication adherence (p=0.02) compared with non-CR, in adjusted analyses. No differences in diet, body weight, or blood pressure control were found between CR and non-CR. Conclusions Vestfold, with comprehensive CR, had a higher participation rate and more risk factors on target than Drammen. Participation in CR in Vestfold was associated with higher levels of smoking cessation and medication adherence, and lower low-density lipoprotein cholesterol, but overall risk factor control is still deficient, underlining the need for improved understanding of barriers to optimal risk factor control.
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| 22. |
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| 23. |
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Perk, Joep, 1945-, et al.
(författare)
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Hälsosamma levnadsvanor i fokus för nya riktlinjer : 2016 års europeiska riktlinjer för hjärt–kärlprevention ger också folkhälsoperspektiv och råd åt beslutsfattare
- 2016
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Ingår i: Läkartidningen. - : Läkartidningen förlag. - 0023-7205 .- 1652-7518. ; 113:43, s. 1862-1862
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Nyligen publicerades en ny version av de europeiska riktlinjerna för kardiovaskulär prevention [1]. Tio större organisationer inom Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice har tagit fram publikationen. Dokumentet är en uppdatering av 2012 års publikation [2] och följer väsentligen samma struktur: Vad är kardiovaskulär prevention, vem behöver det, hur och var ska det erbjudas? Här presenterar vi några av de viktigaste nyheterna, t ex att riktlinjerna nu även inkluderar ett folkhälsoperspektiv i ett avsnitt med rekommendationer om prevention på befolkningsnivå. För första gången presenteras i detta sammanhang vetenskaplig evidens och råd åt beslutsfattare.
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| 28. |
- Perk, Joep, 1945-, et al.
(författare)
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Improving childrens’ lifestyle : the Cool School Project
- 2009
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Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation. - : Sage Publications. - 1741-8267 .- 1741-8275. ; 16:Supplement 1, s. S30-
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Tidskriftsartikel (refereegranskat)
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| 29. |
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| 30. |
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| 31. |
- Perk, Joep, 1945-, et al.
(författare)
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Ny vårdmodell för prevention efter akut kranskärlssjukdom
- 2016
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Ingår i: Läkartidningen. - : Swedish Medical Association. - 0023-7205 .- 1652-7518. ; 113:51-52, s. 1-3
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Kardiologföreningens arbetsgrupp för levnadsvanor och arbetsgruppen för SPICI-studien har tillsammans med Riksförbundet HjärtLung tagit fram en ny vårdmodell för prevention/rehabilitering vid kranskärlssjukdom.
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| 32. |
- Perk, Joep, 1945-
(författare)
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Nya europeiska riktlinjer för kardiovaskulär prevention
- 2012
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; :34, s. 1463-1463
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- 2012 års europeiska riktlinjer för kardiovaskulär prevention i klinisk praxis utgår från några nyckelfrågor: Vad är kardiovaskulär prevention, varför behövs den och för vem, hur och var bör den erbjudas?Riktlinjedokumentet är kortare och rekommendationerna för vården är tydligare än tidigare riktlinjer.Fyra nivåer av kardiovaskulär risk definieras, och riktade preventiva råd ges för varje riskgrupp.Sverige är numera ett lågriskland för hjärt–kärlsjukdom.
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| 33. |
- Perk, Joep, 1945-
(författare)
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Riktlinjer för primär hjärt-kärlprevention efterlevs inte i klinisk praxis. EURIKA-studien visar brister i Europa
- 2012
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; :23, s. 1164-1166
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Tidskriftsartikel (refereegranskat)abstract
- för primär kardiovaskulär prevention tillämpades i tolv länder för öppenvårdspatienter >50 år med åtminstone en riskfaktor för kardiovaskulär sjukdom.Studien visar att gapet mellan riktlinjer och praxis förblir för stort.Av hypertoniker uppnådde 39 procent målnivån för blodtrycket, och av patienter med hyperlipidemi uppnådde 41 procent målnivån för totalkolesterol och LDL-kolesterol.Endast 37 procent av diabetikerna (typ 2-diabetes) var välreglerade.Information om livsstil var bristfällig; mindre än 40 procent av rökarna deltog i ett rökavvänjningsprogram.I Sverige fanns ett lägre antal välinställda hypertoniker och diabetiker än genomsnittet för de övriga länderna.
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| 34. |
- Perk, Joep, 1945-
(författare)
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Risk factor management, a practical guide
- 2009
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Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation. - : Oxford University Press (OUP). - 1741-8267 .- 1741-8275. ; 16:Supplement 2, s. S24-S28
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Tidskriftsartikel (refereegranskat)
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| 35. |
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| 37. |
- Perk, Joep, 1945-
(författare)
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Too much of a good thing?
- 2019
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 40:4, s. 334-334
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 38. |
- Rodríguez-Artalejo, Fernando, et al.
(författare)
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Rationale and methods of the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA)
- 2010
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- The EURIKA study aims to assess the status of primary prevention of cardiovascular disease (CVD) acrossEurope. Specifically, it will determine the degree of control of cardiovascular risk factors in current clinical practice in relation to the European guidelines on cardiovascular prevention. It will also assess physicians' knowledge and attitudes about CVD prevention as well as the barriers impeding effective risk factor management in clinical practice.
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| 43. |
- Sverre, E., et al.
(författare)
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Challenges in coronary heart disease prevention - experiences from a long-term follow-up study in Norway
- 2021
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Ingår i: Scandinavian Cardiovascular Journal. - : Taylor & Francis Group. - 1401-7431 .- 1651-2006. ; 55:2, s. 73-81
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To determine longitudinal changes in lifestyle behaviour and lipid management in a chronic coronary heart disease (CHD) population. Design. A multi-centre cohort study consecutively included 1127 patients at baseline in 2014-2015, on average 16 months after a CHD event. Data were collected from hospital records, a questionnaire and clinical examination. Seven hundred and seven of 1021 eligible patients participated in a questionnaire-based follow-up in 2019. Data were analysed with univariate statistics. Results. After a mean follow-up of 4.7 years (SD 0.4) from baseline, the percentage of current smokers (15% versus 16%), obesity (23% versus 25%) and clinically significant symptoms of anxiety (21% versus 17%) and depression (13% versus 14%) remained unchanged, whereas the proportion with low physical activity increased from 53% to 58% (p < .001). The proportions with reduced physical activity level were similar in patients over and under 70 years of age. Most patients were still taking statins (94% versus 92%) and more patients used high-intensity statin (49% versus 54%, p < .001) and ezetimibe (5% versus 15%, p < .001) at follow-up. 73% reported >= 1 primary-care consultation(s) for CHD during the last year while 27% reported no such follow-up. There were more smokers among participants not attending primary-care consultations compared to those attending (19% versus 14%, p = .026). No differences were found for other risk factors. Conclusions. We found persistent suboptimal risk factor control in coronary outpatients during long-term follow-up. Closer follow-up and intensified risk management including lifestyle and psychological health are needed to improved secondary prevention and outcome of CHD.
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| 44. |
- Sverre, Elise, et al.
(författare)
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Optimal blood pressure control after coronary events : the challenge remains
- 2017
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Ingår i: Journal of the American Society of Hypertension. - : Elsevier. - 1933-1711 .- 1878-7436. ; 11:12, s. 823-830
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Tidskriftsartikel (refereegranskat)abstract
- We identified sociodemographic, medical, and psychosocial factors associated with unfavorable blood pressure (BP) control in 1012 patients, hospitalized with myocardial infarction and/or a coronary revascularization procedure. This cross-sectional study collected data from hospital records, a comprehensive self-report questionnaire, clinical examination, and blood samples after 2-36 (mean 17) months follow-up. Forty-six percent had unfavorable BP control (>= 140/90 [80 in diabetics] mm Hg) at follow-up. Low socioeconomic status and psychosocial factors did not predict unfavorable BP control. Patients with unfavorable BP used on average 1.9 (standard deviation 1.1) BP-lowering drugs at hospital discharge, and the proportion of patients treated with angiotensin inhibitors and beta-blockers decreased significantly (P < .001) from discharge to follow-up. Diabetes (odds ratio [OR] 2.4), higher body mass index (OR 1.05 per 1.0 kg/m(2)), and older age (OR 1.04 per year) were significantly associated with unfavorable BP control in adjusted analyses. Only age (standardized beta [beta] 0.24) and body mass index (beta 0.07) were associated with systolic BP in linear analyses. We conclude that BP control was insufficient after coronary events and associated with obesity and diabetes. Prescription of BP-lowering drugs in hypertensive patients seems suboptimal. Overweight and intensified drug treatment thus emerge as the major factors to target to improve BP control. (C) 2017 American Society of Hypertension. All rights reserved.
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| 45. |
- Sverre, E., et al.
(författare)
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Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population
- 2020
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Ingår i: BMC Cardiovascular Disorders. - : BioMed Central. - 1471-2261 .- 1471-2261. ; 20:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background The relative importance of lifestyle, medical and psychosocial factors on the risk of recurrent major cardiovascular (CV) events (MACE) in coronary patients' needs to be identified. The main objective of this study is to estimate the association between potentially preventable factors on MACE in an outpatient coronary population from routine clinical practice. Methods This prospective follow-up study of recurrent MACE, determine the predictive impact of risk factors and a wide range of relevant co-factors recorded at baseline. The baseline study included 1127 consecutive patients 2-36 months after myocardial infarction (MI) and/or revascularization procedure. The primary composite endpoint of recurrent MACE defined as CV death, hospitalization due to MI, revascularization, stroke/transitory ischemic attacks or heart failure was obtained from hospital records. Data were analysed using cox proportional hazard regression, stratified by prior coronary events before the index event. Results During a mean follow-up of 4.2 years from study inclusion (mean time from index event to end of study 5.7 years), 364 MACE occurred in 240 patients (21, 95% confidence interval: 19 to 24%), of which 39 were CV deaths. In multi-adjusted analyses, the strongest predictor of MACE was not taking statins (Relative risk [RR] 2.13), succeeded by physical inactivity (RR 1.73), peripheral artery disease (RR 1.73), chronic kidney failure (RR 1.52), former smoking (RR 1.46) and higher Hospital Anxiety and Depression Scale-Depression subscale score (RR 1.04 per unit increase). Preventable and potentially modifiable factors addressed accounted for 66% (95% confidence interval: 49 to 77%) of the risk for recurrent events. The major contributions were smoking, low physical activity, not taking statins, not participating in cardiac rehabilitation and diabetes. Conclusions Coronary patients were at high risk of recurrent MACE. Potentially preventable clinical and psychosocial factors predicted two out of three MACE, which is why these factors should be targeted in coronary populations.
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| 47. |
- Theorell, Töres, et al.
(författare)
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A systematic review of studies in the contributions of the work environment to ischaemic heart disease development
- 2016
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 26:3, s. 470-477
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Forskningsöversikt (refereegranskat)abstract
- Background: There is need for an updated systematic review of associations between occupational exposures and ischaemic heart disease (IHD), using the GRADE system. Methods: Inclusion criteria: (i) publication in English in peer-reviewed journal between 1985 and 2014, (ii) quantified relationship between occupational exposure (psychosocial, organizational, physical and other ergonomic job factors) and IHD outcome, (iii) cohort studies with at least 1000 participants or comparable case-control studies with at least 50 + 50 participants, (iv) assessments of exposure and outcome at baseline as well as at follow-up and (v) gender and age analysis. Relevance and quality were assessed using predefined criteria. Level of evidence was then assessed using the GRADE system. Consistency of findings was examined for a number of confounders. Possible publication bias was discussed. Results: Ninety-six articles of high or medium high scientific quality were finally included. There was moderately strong evidence (grade 3 out of 4) for a relationship between job strain and small decision latitude on one hand and IHD incidence on the other hand. Limited evidence (grade 2) was found for iso-strain, pressing work, effort-reward imbalance, low support, lack of justice, lack of skill discretion, insecure employment, night work, long working week and noise in relation to IHD. No difference between men and women with regard to the effect of adverse job conditions on IHD incidence. Conclusions: There is scientific evidence that employees, both men and women, who report specific occupational exposures, such as low decision latitude, job strain or noise, have an increased incidence of IHD.
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| 48. |
- Uchmanowicz, Izabella, et al.
(författare)
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Optimising implementation of European guidelines on cardiovascular disease prevention in clinical practice : what is needed?
- 2021
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Ingår i: European Journal of Preventive Cardiology. - : Oxford Academic. - 2047-4873 .- 2047-4881. ; 28:4, s. 426-431
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Tidskriftsartikel (refereegranskat)abstract
- Cardiovascular disease is a model example of a preventable condition for which practice guidelines are particularly important. In 2016, the joint task force created by the European Society of Cardiology (ESC) together with 10 other societies released the new version of the European guidelines on cardiovascular disease prevention. To facilitate the implementation of the ESC guidelines, a dedicated prevention implementation committee has been established within the European Association of Preventive Cardiology. The paper will first explore potential barriers to the guidelines' implementation. It then develops a discussion that seeks to inform the future development of the committee's work, including a new definition of the guidelines' stakeholders (health policy-makers, healthcare professionals and health educators, patient organisations, entrepreneurs and the general public), future activities within four specific areas: strengthening awareness of the guidelines among stakeholders; supporting organisational changes to facilitate the guidelines' implementation; motivating stakeholders to utilise the guidelines; and present ideas on new implementation strategies. Providing multifaceted cooperation between healthcare professionals, healthcare management executives and health policy-makers, the novel approach proposed in this paper should contribute to a wider use of the 2016 ESC guidelines and produce desired effects of less cardiovascular disease morbidity and mortality. Furthermore, the solutions presented within the paper may constitute a benchmark for the implementation of practice guidelines in other medical disciplines.
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| 49. |
- Wiklund, S, et al.
(författare)
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Check-up your hearthealth at the pharmacy
- 2012
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 19:1, s. S82-
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Tidskriftsartikel (refereegranskat)
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| 50. |
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