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Abstract Acute cardiovascular (CV) events occur in deployed military personnel yet little is known about the CV risk profile of deployed U.S. military service members who experience ACS. Stress as a potential confounder of CV events in service members deployed in the ongoing Global War on Terror (GWOT) has not been addressed. The primary aim of this dissertation was to use a case-control design to compare CV risk factors between a group of 93 service members deployed in support of the GWOT who experienced acute coronary syndromes (ACS) and 136 rank, area of operations, and ethnicity-matched controls who did not experience ACS while deployed in support of GWOT. The matching variables controlled for the confounding effects of SES, stress, and ethnicity. Of the 93 ACS cases, 81.7% had an acute myocardial infarction and 18.3% had unstable angina. Most major CV risk factors were significantly different between the two groups except blood sugar and history of dyslipidemia. In a univariate conditional logistic regression model, all CV risk factors except blood sugar were significant predictors of ACS. In a multivariate logistic regression model, higher age [1.24 (1.11, 1.40)], higher total cholesterol/high density lipoprotein cholesterol ratio [2.85 (1.65, 4.93)], and family history of premature coronary artery disease [4.93 (1.66, 14.64)] remained significant independent predictors of ACS in service personnel deployed overseas in the GWOT. Both groups had Framingham risk scores that categorized them as "low risk". Improved CV health surveillance programs are needed in the military population to identify those with multiple CV risk factors. Interventions to reduce CV risk in military service members, especially prior to an overseas deployment, are essential. Based on the findings of this study, additional biomarkers that enhance the predictive ability of the Framingham risk score must be sought to improve a clinician's ability to stratify cardiac risk in young military men.

Background: Hospitalised COVID-19 patients with underlying cardiovascular disease (CVD) and cardiovascular risk factors appear to be at risk of poor outcome. It is unknown if these patients should be considered a vulnerable group in healthcare delivery and healthcare recommendations during the COVID-19 pandemic. Methods: A systematic literature search was performed to answer the following question: In which hospitalised patients with proven COVID-19 and with underlying CVD and cardiovascular risk factors should doctors be alert to a poor outcome? Relevant outcome measures were mortality and intensive care unit admission. Medline and Embase databases were searched using relevant search terms until 9 June 2020. After systematic analysis, 8 studies were included. Results: Based on the literature search, there was insufficient evidence that CVD and cardiovascular risk factors are significant predictors of mortality and poor outcome in hospitalised patients with COVID-19. Due to differences in methodology, the level of evidence of all studies was graded 'very low' according to the Grading Recommendations Assessment, Development and Evaluation methodology. It is expected that in the near future, two multinational and multicentre European registries (CAPACITY-COVID and LEOSS) will offer more insight into outcome in COVID-19 patients. Conclusion: This literature review demonstrated there was insufficient evidence to identify CVD and cardiovascular risk factors as important predictors of poor outcome in hospitalised COVID-19 patients. However, patients with CVD and cardiovascular risk factors remain vulnerable to infectious disease outbreaks. As such, governmental and public health COVID-19 recommendations for vulnerable groups apply to these patients.

Objectives: Cardiovascular diseases are the most common causes of premature death in patients with schizophrenia. We aimed at reducing cardiovascular risk factors in non-selected outpatients with schizophrenia using methods proven effective in short-term trials. Furthermore, we examined whether any baseline characteristics were associated with positive outcomes. Methods: All outpatients treated for schizophrenia at two Danish hospitals were included in this 1-year follow-up study. The patients were offered health interventions both individually and in groups. Weight, waist circumference, blood glucose, serum lipids, and information on smoking and alcohol were obtained. Results: On average, small significant increases in body mass index (BMI) and waist circumferences were observed while small non-significant improvements in other cardiovascular risk factors were seen. Patients with high baseline BMI and patients with duration of treated illness beyond 2 years had significantly better intervention outcomes. Conclusions: Our results show that it was difficult to improve physical health in a group of non-selected patients with schizophrenia as part of routine care. The patients were not easily motivated to participate in the interventions, and it was difficult to monitor the recommended metabolic risk measures in the patient group. Future research should focus on simple strategies in health promotion that can be integrated into routine care.

The presence of medical comorbidities in women with psychotic disorders can lead to poor medical and psychiatric outcomes. Of all comorbidities, cardiovascular disease is the most frequent, and the one most likely to cause early death. We set out to review the evidence for cardiovascular risk factors (CRFs) in women with schizophrenia-related disorders and for interventions commonly used to reduce CRFs. Electronic searches were conducted on PubMed and Scopus databases (2017–2022) to identify papers relevant to our aims. A total of 17 studies fulfilled our inclusion criteria. We found that CRFs were prevalent in psychotic disorders, the majority attributable to patient lifestyle behaviors. We found some inconsistencies across studies with regard to gender differences in metabolic disturbances in first episode psychosis, but general agreement that CRFs increase at the time of menopause in women with psychotic disorders. Primary care services emerge as the best settings in which to detect CRFs and plan successive intervention strategies as women age. Negative symptoms (apathy, avolition, social withdrawal) need to be targeted and smoking cessation, a heart-healthy diet, physical activity, and regular sleep routines need to be actively promoted. The goal of healthier hearts for women with psychotic disorders may be difficult, but it is achievable.

We conducted a cross sectional study of cardiovascular risk factors among healthcare workers at four government hospitals in Kelantan, Malaysia. We randomly selected 330 subjects fulfilling the following study criteria: those who had been working for at least one year at that health facility, Malaysians citizens and those with some form of direct contact with patients. We conducted an interview, obtained physical measurements, a fasting blood sugar and fasting lipid profiles among 308 subjects. The mean age of the subjects was 43.5 years, 82% were female; 30.8%, 14.3%, 10.4%, 1.3% and 1.6% of the subjects had dyslipidemia, hypertension, diabetes mellitus, a history of stroke and a history of ischemic heart disease, respectively. Forty-two percent of subjects had at least one medical condition. The mean body mass index (BMI) was 27.0 kg/m2 (SD=4.8) and 24.3% haM BMI >30 kg/m2. The mean systolic and diastolic blood pressures were 121.5 mmHg (SD=14.0) and 76.5 mmHg (SD=9.7), respectively and the mean waist-hip ratio was 0.84 (SD=O.I). The mean fasting blood sugar, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein were 5.8 mmol/l (SD=2.4), 5.5 mmol/l (SD=1.0), 1.4 mmol/l (SD=0.9), 1.5 mmol/l (SD=0.3) and 3.5 mmol/l (SD=0.9), respectively. Our study population had a smaller proportion of hypertension than that of the general Malaysian population. They had higher fasting total cholesterol, slightly lower fasting blood sugar, with a large proportion of them, obese and had diabetes. Immediate intervention is needed to reduce the traditional cardiovascular risk factors in this population.

Introduction The increasing prevalence of cardiovascular risk factors is mainly due to habits acquired during one's life. However, military training has physical aptitude as one of its main objectives. The objective of the data analysis was to analyze the practiced physical activity, which is the most active age group and if the intensity of the physical activity influences the various parameters being analyzed. Methodology This evaluation focuses on some cardiovascular parameters like the incidence of family history, medication, smoking habits and blood pressure/heart frequency measurements; data from blood tests to examine the biochemistry; body composition through weight, height, abdominal perimeter and, through DXA, body fat; and with accelerometry the physical activity level has been determined. Results Sedentary physical activity is significantly greater during weekends instead of moderate and intense levels, which occur mainly during work-days. People who are between 45 and 54 years old are the ones who takes more anticholesterolemic medicine and also the one who show the best HDL values. The sedentary level of physical activity is positively and directly related with weight, which presents an inverse correlation with moderate physical activity, and also body fat parameters and abdominal perimeter. The highest prothrombin time levels and sedimentation speed are associated with sedentary physical activity. However, even though HDL levels are significantly greater when intense physical activity is practiced, this also creates higher values of INR. Intense physical activity is also responsible for some ischemic heart disease, reflecting an increase in CK-MB values. Discussion The abdominal perimeter proved to be a better predictor of intra-abdominal fat than the BMI. The youngest age group showed really high values of PCR, protein being a contributing factor for heart disease risk (Albert, Glynn & Ridker, 2003). The relation between physical activity and fat was inverse (Cederberg et al, 2011), while HDL results were better as physical activity increased (Gordon-Larsen et al, 2009). Physical activity intensity above average show little to no benefits (AAdahl, KJæer & Jørgensen, 2007), just like the increase of circulation CK-MB however, sedentary ones showed more changes when it came to coagulation. Balanced physical activity was moderate when it came to benefits/disadvantages.

宿泊型健康指導プログラムの有効性を立証 --1年後の体重・腹囲・non-HDLコレステロールを有意に改善--. 京都大学プレスリリース. 2019-01-15. ; Lifestyle modification is the primary treatment strategy for obesity, hypertension, dyslipidemia, and hyperglycemia. Recently, the Japanese government designed a healthcare retreat program for persons with cardiovascular risk factors. However, the structure and effectiveness of this program has not been fully discussed. Employees of a company group with obesity and one or more other cardiovascular risk factors were enrolled in the study. The participants in the three-day retreat program were compared with those receiving a brochure-based advice for their subsequent changes in the annual health check-up data using the propensity score matching method. Among the 415 eligible employees, 220 underwent the intensive program and 195 received a brochure-based advice. In the propensity score-matched subjects, reduction in body weight (2.7 kg vs. 0.99 kg, p < 0.01), waist circumference (3.5 cm vs. 1.5 cm, p < 0.01), and non-HDL cholesterol (8.8 mg/dl vs. 1.3 mg/dl, p = 0.05) were significantly greater in the intensive care group one year later. The superiority of the intensive program, however, was gradually attenuted for subsequent two years later. This healthcare retreat with counseling and training program would improve body weight and waist circumference for one to two subsequent years.

Purpose.To examine the effects of a Tai Chi Chung (TCC) program, an efficiency approach, on anxiety and cardiovascular risk factors.Design.A quasi-experimental study.Setting.A community in Taipei City, Taiwan.Subjects.One hundred thirty-three adults aged 55 years and older.Intervention.Sixty-four participants (experimental group) attended a 60-minute Tai Chi exercise three times per week for 12 weeks, whereas 69 participants (control group) maintained their usual daily activities.Measures.Anxiety states, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and waist circumference (WC) were assessed at baseline, 6 weeks into the experiment, and 12 weeks into the experiment.Analysis.Generalized estimating equations were used to evaluate the changes.Results.Participants showed a greater drop in anxiety levels (β = −2.57, p = .001) and DBP (β = −7.02, p < .001) at the 12-week follow-up than did the controls. SBP significantly decreased in the 6-week follow-up and 12-week follow-up tests. The participants in the intervention achieved a greater drop in BMI at the 6-week and 12-week follow-up visits than the controls. The interventions demonstrated decreased average WC at the 6-week and 12-week follow-up visits as compared to the controls.Conclusion.The results highlight the long-term benefits of a TCC program in facilitating health promotion by reducing anxiety and risk factors for cardiovascular diseases.