RESUMEN
The COVID-19 pandemic has had a significant impact on the quality of life (QoL), daily lifestyle, and mental health of people suffering from a mental disorder. This study aimed to investigate the effects of the prolongation of the COVID-19 emergency on QoL and lifestyles in a sample of 100 outpatients at the Psychiatry Unit in Palermo University Hospital, Italy. QoL was measured through the 12-item Short Form Survey and the COV19-Impact on Quality of Life. Lifestyle changes during the pandemic were measured through the lifestyle change questionnaire. The majority of participants reported a great impact of COVID-19 on the QoL, and almost half reported worsened lifestyles. Worsened lifestyles were predictive of both poor mental and physical health related QoL. These results suggest that people with mental illness need interventions targeting lifestyles, and the mental health service in Italy should adjust to the ongoing pandemic, developing virtual treatments.
Asunto(s)
COVID-19 , Trastornos Mentales , Humanos , Calidad de Vida , Pandemias , COVID-19/epidemiología , Estilo de Vida , Trastornos Mentales/complicaciones , Trastornos Mentales/epidemiologíaRESUMEN
BACKGROUND: Improving cardiovascular risk prediction continues to be a major challenge and effective prevention of cardiovascular disease. Accordingly, several studies have recently reported on the role of cardiovascular risk education. This study was designed to evaluate the impact of education on global cardiovascular risk in hypertensive patients. SUBJECTS AND METHODS: The study population consisted of 223 consecutive hypertensive outpatients. Their educational status was categorized according to the number of years of formal education as follows: (1) low education (less than 10 years) and (2) medium-high education (10-15 years). RESULTS: In both groups, cardiometabolic comorbidities, global cardiovascular risk and echocardiographic measurements were analysed. Less educated hypertensive subjects were characterized by a significantly higher prevalence of patients with metabolic syndrome (MetS) (p < .01), greater global cardiovascular risk (p < .001), and a higher consumption of antihypertensive drugs (p < .01) rather than medium-high educated hypertensive subjects. In the same subjects, a significant increase in microalbuminuria (MA) (p < .01) and a significant decrease in E/A (p < .001) ratio was found. Univariate analysis indicated that global cardiovascular risk correlated directly with waist-hip ratio, mean blood pressure, MA, left ventricular mass index, MetS and inversely with education (r = -0.45; p < .001). Education was independently (p < .001) associated with global CV risk. CONCLUSIONS: Our data suggest that education may be considered the best predictor of global cardiovascular risk in hypertensives and thus has to be evaluated in the strategies of hypertension and cardiovascular risk management.
Asunto(s)
Enfermedades Cardiovasculares , Escolaridad , Hipertensión , Síndrome Metabólico/epidemiología , Adulto , Albuminuria/diagnóstico , Antihipertensivos/uso terapéutico , Determinación de la Presión Sanguínea/métodos , Índice de Masa Corporal , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Comorbilidad , Estudios Transversales , Ecocardiografía/métodos , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/fisiopatología , Italia/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Conducta de Reducción del Riesgo , Relación Cintura-CaderaRESUMEN
OBJECTIVE: This study was designed to evaluate the relationship among circulating adiponectin (ADPN), left ventricular mass (LVM) and cardio-metabolic comorbidities in subjects at higher global cardiovascular risk (score of"Cuore Project"). METHODS: 115 consecutive subjects were grouped according to normal or low ADPN levels. Left ventricular internal diameter (LVID/h), total LV mass (LVM), LVM index (LVMI), relative wall thickness (RWT), LV ejection fraction by echocardiography and diastolic parameters, by pulsed-wave Doppler were calculated. RESULTS: Low-ADPN subjects were characterized by a significantly higher prevalence of some cardiometabolic comorbidities (obesity, visceral obesity, diabetes and insulin resistance, LVH, metabolic syndrome (MetS), coronary artery syndrome (CAD). BMI (P < 0.0001), WHR (P < 0.03), trigly cerides (P < 0.001), HOMA-IR (P < 0.001), LVM, LVMI, IVST and RWT (P < 0.0001) were significantly higher and HDL-C (P < 0.001) and LVEF were significantly lower in low-ADPN than in normal-ADPN subjects. LVMI correlated directly with BMI (P < 0.001), WHR (P < 0.001) MBP (P < 0.001), MetS (P < 0.001) and inversely with ADPN (P < 0.0001). Multiple regres- sion analysis indicated that ADPN was independently associated with LVMI. CONCLUSIONS: ADPN might be considered a key component mediating the cross-talk between adipose tissue, cardiac cells and the vasculature. Accordingly, its routine measurement might become a new target in the management of global CV risk.
Asunto(s)
Adiponectina/sangre , Enfermedades Cardiovasculares/sangre , Ventrículos Cardíacos/diagnóstico por imagen , Medición de Riesgo/métodos , Función Ventricular Izquierda/fisiología , Biomarcadores/sangre , Volumen Cardíaco , Enfermedades Cardiovasculares/diagnóstico por imagen , Enfermedades Cardiovasculares/epidemiología , Ecocardiografía Doppler de Pulso , Femenino , Ventrículos Cardíacos/fisiopatología , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , Factores de Riesgo , Volumen SistólicoRESUMEN
This study was designed to evaluate the impact of educational status on global cardiovascular risk in a southern Italian urban population. The study population consisted of 488 consecutive outpatients aged 18 years and older. Educational status was categorized according to the number of years of formal education as follows: (1) low education group (<10 years) and (2) medium-high education group (10-15 years). In both groups, cardiometabolic comorbidities (obesity, visceral obesity, diabetes, dyslipidemia, metabolic syndrome, microalbuminuria, left ventricular hypertrophy) and global cardiovascular risk, according to international guidelines, were analyzed. Left ventricular mass index and ejection fraction by echocardiography and E/A ratio, by pulsed-wave Doppler, were calculated. The low education group was characterized by a significantly higher prevalence of patients with visceral obesity (P=.021), hypertension (P=.010), metabolic syndrome (P=.000), and microalbuminuria (P=.000) and greater global cardiovascular risk (P=.000). Significantly increased levels of microalbuminuria (P=.000) and significantly decreased values of E/A ratio (P=.000) were also detected in the low education group. Global cardiovascular risk correlated directly with waist-to-hip ratio (P=.010), microalbuminuria (P=.015), and the metabolic syndrome (P>.012) and inversely with educational status (P=.000). Education was independently (P=.000) associated with global cardiovascular risk. These data indicate a strong association between low education and cardiometabolic comorbidities suitable to influence the evolution of chronic degenerative diseases. Preventive strategies need to be more efficient and more effective in this patient population.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Escolaridad , Adulto , Índice de Masa Corporal , Enfermedades Cardiovasculares/mortalidad , Estudios Transversales , Femenino , Humanos , Italia/epidemiología , Modelos Lineales , Masculino , Persona de Mediana Edad , Prevalencia , Análisis de Regresión , Factores de Riesgo , Factores Socioeconómicos , Población Urbana , Relación Cintura-CaderaRESUMEN
This study was designed to evaluate the prevalence of cardiometabolic comorbidities and the changes in left ventricular geometry and function in 135 subjects subgrouped according to low or normal total adiponectin plasma (ADPN) levels. Left ventricular (LV) internal diameter/height, total LV mass (LVM) and LVM index (LVMI), relative wall thickness (RWT), LV ejection fraction by echocardiography and diastolic parameters by pulsed-wave Doppler were calculated. Body mass index (BMI) (p < 0.0001), waist-to-hip ratio (p < 0.03), triglycerides (p < 0,001), prevalence of obesity (p < 0.005), visceral obesity (p < 0.003), left ventricular hypertrophy (LVH) (p < 0.001), metabolic syndrome (p < 0.0003) and coronary artery disease (CAD) (p < 0.003) were significantly increased and high-density lipoprotein-cholesterol (p < 0.001) was significantly reduced in hypo-ADPN than normal-ADPN subjects. LVM, LVMI, interventricular septum thickness and RWT were significantly (p < 0.0001) higher and left ventricular ejection fraction was significantly (p < 0.0002) lower in hypo-ADPN than normal-ADPN patients. LVMI correlated directly with BMI (p < 0.001), mean blood pressure (p < 0.001), metabolic syndrome (MetS) (p < 0.001) and inversely with ADPN (p < 0.0001). The prevalence of LVH (p < 0.001) and CAD (p < 0.01) was higher in subjects with normal-ADPN and MetS, while the presence of MetS did not change this finding in hypo ADPN group. Both models of regression analysis indicated that ADPN and BMI resulted independently associated with LVMI. In conclusion, our data seem to indicate that hypoadiponectinemia might be associated with an increased prevalence both of clinical comorbidities and increased LVMI. In this subset of subjects, ADPN and BMI, more than MetS, are able to explain cardiac damage. Accordingly, ADPN might become a new target in the management of cardiometabolic risk.