Carotid Stiffness and Physical Activity in Elderly—A Short Report of the SAPALDIA 3 Cohort Study

Caviezel, Seraina; Dratva, Julia; Schaffner, Emmanuel; Schindler, Christian; Endes, Simon; Autenrieth, Christine S.; Wanner, Miriam; Martin, Brian W.; Groot, Eric de; Gaspoz, Jean‐Michel; Künzli, Nino; Probst‐Hensch, Nicole; Schmidt‐Trucksäss, Arno

doi:10.1371/journal.pone.0128991

Cited by 6 publications

(7 citation statements)

References 29 publications

(31 reference statements)

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“…The average of two consecutive measurements at 3-5 minute intervals and of both body sides was taken for analyses. The CAVI and baPWV reproducibility was previously shown to be high in this Caucasian cohort [28]. CAVI reflects arterial stiffness of the aorta and the iliac, femoral and tibial arteries [25] and baPWV between the brachial and tibial arteries [29].…”

Section: Arterial Stiffness Measurementmentioning

confidence: 60%

Physical activity is associated with lower arterial stiffness in older adults: results of the SAPALDIA 3 Cohort Study

et al. 2015

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Associations of physical activity (PA) intensity with arterial stiffness in older adults at the population level are insufficiently studied. We examined cross-sectional associations of self-reported PA intensities with arterial stiffness in elderly Caucasians of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults. Mixed central and peripheral arterial stiffness was measured oscillometrically by the cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). The self-reported International Physical Activity Questionnaire long version was administered to classify each subject's PA level. We used univariable and multivariable mixed linear and logistic regression models for analyses in 1908 persons aged 50 years and older. After adjustment for several confounders moderate, vigorous and total PA were inversely associated with CAVI (p = 0.02-0.03). BaPWV showed negative and marginally significant associations with vigorous and moderate PA (each p = 0.06), but not with total PA (p = 0.28). Increased arterial stiffness (CAVI 9, upper tertile) was inversely and significantly associated with vigorous PA [odds ratio (OR) 0.65, 95 % confidence interval (CI) 0.48-0.88], and marginally significantly with total PA (OR 0.76, 95 % CI 0.57-1.02) and moderate PA (OR 0.75, 95 % CI 0.56-1.01). The odds ratio for baPWV 14.4 was 0.67 (95 % CI 0.48-0.93) across the vigorous PA levels, and was non-significant across the total (OR 0.91, 95 % CI 0.66-1.23) and moderate PA levels (OR 0.94, 95 % CI 0.69-1.28). In this general Caucasian population of older adults higher levels especially of vigorous PA were associated with lower arterial stiffness. These data support the importance of PA for improving cardiovascular health in elderly people.

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Section: Arterial Stiffness Measurementmentioning

confidence: 60%

Physical activity is associated with lower arterial stiffness in older adults: results of the SAPALDIA 3 Cohort Study

et al. 2015

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“…The country has a physician to population ratio of 0.473 to 1000 20 ; and is much less in rural areas of Pakistan given that 60% of medical graduates have the ambition to migrate out of the country for better opportunities. 21 More than 1100 physicians migrated out of the country out of an estimated 5400 graduates in 2006 20 and such brain drain is projected to further escalate in future. Recurrent cost on HRH in PHC account for the 80% of total cost of running PHC services in Pakistan.…”

Section: Hrh Situation In Pakistanmentioning

confidence: 99%

Motivation and Retention of Physicians in Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan

Shah

Zaidi

Ahmed

et al. 2016

Int J Health Policy Manag

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Background: Workforce motivation and retention is important for the functionality and quality of service delivery in health systems of developing countries. Despite huge primary healthcare (PHC) infrastructure, Pakistan's health indicators are not impressive; mainly because of under-utilization of facilities and low patient satisfaction. One of the major underlying issues is staff absenteeism. The study aimed to identify factors affecting retention and motivation of doctors working in PHC facilities of Pakistan. Methods: An exploratory study was conducted in a rural district in Khyber Puktunkhwa (KP) province, in Pakistan. A conceptual framework was developed comprising of three organizational, individual, and external environmental factors. Qualitative research methods comprising of semi-structured interviews with doctors working in basic health units (BHUs) and in-depth interviews with district and provincial government health managers were used. Document review of postings, rules of business and policy actions was also conducted. Triangulation of findings was carried out to arrive at the final synthesis. Results: Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies and medical facilities contributed to lack of motivation among both male and female doctors. The physicians accepted government jobs in BHUs with a belief that these jobs were more secure, with convenient working hours. Male physicians seemed to be more motivated because they faced less challenges than their female counterparts in BHUs especially during relocations. Overall, the organizational factors emerged as the most significant whereby human resource policy, career growth structure, performance appraisal and monetary benefits played an important role. Gender and marital status of female doctors was regarded as most important individual factor affecting retention and motivation of female doctors in BHUs. Conclusion: Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies, and medical facilities contributed to lack of motivation in physicians in our study. Our study advocates that by addressing the retention and motivation challenges, service delivery can be made more responsive to the patients and communities in Pakistan and other similar settings.

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“…Increased levels of these characteristics are known to increase the risk for stroke, other cardiovascular events, and mortality . Several studies conducted in the general population investigated the association of physical activity with CIMT and markers of stiffness . Most studies found an association between a higher level of physical activity and less carotid or aortic stiffness, lower CIMT, and less progression of CIMT, although some studies did not show these associations .…”

Section: Introductionmentioning

confidence: 99%

“…Several studies conducted in the general population investigated the association of physical activity with CIMT and markers of stiffness . Most studies found an association between a higher level of physical activity and less carotid or aortic stiffness, lower CIMT, and less progression of CIMT, although some studies did not show these associations . Studies in patients with vascular disease are not available; however, there is circumstantial evidence that the benefits of physical activity on CIMT in patients with vascular risk factors and on endothelial function are more pronounced in patients with vascular disease .…”

Section: Introductionmentioning

confidence: 99%

Physical Activity and Characteristics of the Carotid Artery Wall in High‐Risk Patients—The SMART (Second Manifestations of Arterial Disease) Study

Boss

Graaf

Visseren

et al. 2017

JAHA

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BackgroundPhysical activity reduces the risk of vascular disease. This benefit is not entirely explained through an effect on vascular risk factors. We examined the relationship of physical activity and characteristics of the carotid artery wall in patients with vascular disease or risk factors.Methods and ResultsCross‐sectional analyses were performed in 9578 patients from the SMART (Second Manifestations of Arterial Disease) study, a prospective cohort study among patients with vascular disease or risk factors. Physical activity was assessed using questionnaires. Carotid intima‐media thickness and carotid artery stenosis of both common carotid arteries was measured. In a subset of 3165 participants carotid diastolic diameter and distension were assessed. Carotid stiffness was expressed as the distensibility coefficient and Young's elastic modulus. Regression analyses adjusted for vascular risk factors showed that physical activity was inversely associated with diastolic diameter (fifth versus first quintile B=−0.13 mm; 95% CI, −0.21 to −0.05) and decreased risk of carotid artery stenosis (relative risk, 0.58; 95% CI, 0.48–0.69). A light level of physical activity was associated with less carotid stiffness (second versus first quintile; Young's elastic modulus B=−0.11 kPa−1×10−3; 95% CI, −0.16 to −0.06; distensibility coefficient B=0.93 kPa×103; 95% CI, 0.34–1.51), but there was no additional benefit with increasing levels of physical activity. In patients with vascular disease, physical activity was inversely associated with common carotid intima‐media thickness, but not in patients with vascular risk factors.ConclusionsIn patients with vascular disease or risk factors, increased physical activity was associated with smaller carotid diastolic diameter, decreased risk of carotid artery stenosis, and less carotid stiffness, but it only showed benefits on carotid intima‐media thickness in patients with vascular disease.

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Carotid Stiffness and Physical Activity in Elderly—A Short Report of the SAPALDIA 3 Cohort Study

Cited by 6 publications

References 29 publications

Physical activity is associated with lower arterial stiffness in older adults: results of the SAPALDIA 3 Cohort Study

Physical activity is associated with lower arterial stiffness in older adults: results of the SAPALDIA 3 Cohort Study

Motivation and Retention of Physicians in Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan

Physical Activity and Characteristics of the Carotid Artery Wall in High‐Risk Patients—The SMART (Second Manifestations of Arterial Disease) Study

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