Motivating patients to exercise

Li, Chu-Shiu; Liu, Chwen-Chi; Tsai, Min-Kuang; Tai, Ya-Ping; Wai, Jackson Pui Man; Tsao, Chwen-Keng; Wen, Chi‐Pang

doi:10.1097/hjh.0000000000000392

Cited by 5 publications

(3 citation statements)

References 28 publications

(36 reference statements)

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“…In a study among individuals with hypercholesterolemia, Williams and Franklin found that ≥3.6 MET‐h/d of running or walking compared with ≤1.07 MET‐h/d was associated with a 37% lower risk of fatal CVD and a 26% lower risk of nonfatal CVD after adjusting for other risk factors 8. In a study of 470 163 Taiwanese adults, Li et al reported that, among hypertensive individuals, risk of mortality was 37% higher for those who were inactive compared with those who were active 6. Among participants in the Harvard Alumni Health Study, Paffenbarger et al found that men with a high level of physical activity (≥2000 kcal/wk) had lower rates of heart attack than those with a low level of physical activity (<2000 kcal/wk), even in the presence of various cardiovascular risk factors, including older age, smoking, and obesity 9.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, this inverse association has been shown in various high‐risk subgroups, including older adults, current smokers, and adults with diabetes mellitus (DM), hypercholesterolemia, or hypertension 2, 3, 5, 6, 7, 8, 9, 10. Although physical activity reduces CVD risk in people with and without single CVD risk factors, it is unclear if physical activity is equally beneficial for prevention of CVD among women with varying levels of global cardiovascular risk.…”

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confidence: 99%

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Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Chomistek

Cook

Rimm

et al. 2018

JAHA

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BackgroundThe inverse association between physical activity and cardiovascular disease (CVD) is well‐ established and has previously been shown in people with and without single CVD risk factors. We examined whether level of global cardiovascular risk, on the basis of the pooled cohort equation or Reynolds risk score, which include multiple risk factors, modified the physical activity–CVD association.Methods and ResultsParticipants in the prospective WHS (Women's Health Study; n=27 536) reported their leisure‐time physical activity at study entry (1992–1995) and during follow‐up through 2013. Participants were divided into 10‐year cardiovascular risk groups on the basis of the pooled cohort equation and Reynolds risk score. The primary outcome was incident total CVD. The CVD hazard ratio for active (≥500 kcal/wk of physical activity) compared with inactive (<500 kcal/wk) individuals was 0.73 (95% confidence interval, 0.66–0.80) in multivariable models. This association was not modified by level of cardiovascular risk; physical activity was inversely associated with CVD within all pooled cohort equation and Reynolds risk score groups (P=0.17 and P=0.66 for interaction, respectively). When the joint association of physical activity and level of cardiovascular risk was examined, women with higher risk on the basis of either the pooled cohort equation or Reynolds risk score had higher CVD rates compared with those at low risk, regardless of physical activity. However, among women at both high and low risk, being physically active was associated with lower risk of CVD events.ConclusionsIn this large prospective cohort of women, level of global cardiovascular risk did not modify the inverse association between leisure‐time physical activity and incident CVD. Thus, promoting physical activity is important in women at both low and high cardiovascular risk.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Chomistek

Cook

Rimm

et al. 2018

JAHA

View full text Add to dashboard Cite

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“…45 The mortality risk of being inactive was estimated to be equivalent to an increase of approximately 40 mm Hg in systolic blood pressure or 20 mm Hg in diastolic blood pressure, a number relevant to patients with hypertension. 46 However, it has been proven that encouraging people to be more active is not easy. 45 Additional support at the organizational level should be encouraged, and wider contextual factors that impinge on the delivery of and response to the intervention should be considered.…”

Section: Discussionmentioning

confidence: 99%

Family member-based supervision of patients with hypertension: a cluster randomized trial in rural China

et al. 2016

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Empirical evidence has suggested that social support from family can help patients take their medicines correctly. This study aims to evaluate the role of a family member-based supervision package in the management of hypertension using a cluster randomized trial in rural China. We recruited patients with hypertension from four villages in Yangzhong and randomly allocated them to the control group (n=288) and the intervention group (n=266). A family member-based supervision package was applied to the intervention group, while the usual service was applied to the controls. Patients were followed for 12 months and completed face-to-face interviews at the end of 6 and 12 months. The primary outcomes were patients' medication adherence and frequency of blood pressure measurement. Secondary outcomes included changes in blood pressure, altered risk behaviours and occurrence of hypertension-related complications. To control for the effects of cluster randomization, multilevel mixed-effects regression models were used to compare group changes. We observed that the intervention improved patients' blood pressure measurement frequency (OR: 9.00, 95% CI: 4.52–17.91) and adherence to antihypertensive treatment (OR: 1.74, 95% CI: 0.91–3.32). Its effect on the blood pressure control rate was significant at the mid-term investigation (OR: 0.67, 95% CI: 0.40–0.93), but the long-term effect was not significant (OR: 0.89, 95% CI: 0.64–1.26). After 6 months of intervention, either systolic or diastolic blood pressure was significantly decreased in the intervention group. However, this difference was not significant at the final investigation. Findings from this study revealed that the family member-based supervised therapy may have positive effects on patients' adherence to blood monitoring and hypertensive medications.

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The ability of physical activity in reducing mortality risks and cardiovascular loading and in extending life expectancy in patients with COPD

Lee

Tsai

et al. 2021

Sci Rep

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For chronic obstructive pulmonary disease (COPD), the role of physical activity in reducing COPD mortality and heart loading and in extending life expectancy remains unclear. Participants in comprehensive medical screening were recruited with spirometry on everyone. We analyzed physical activity volume calculated from intensity, duration and frequency of self-reported exercise history. Deaths were identified from the National Death File. The impacts of physical activity on mortality, heart rate and life expectancy were analyzed. Among the cohort of 483,603 adults, 32,535 had spirometry-determined COPD, indicating an adjusted national prevalence of 11.4% (male) and 9.8% (female). On the average, COPD increased all-cause mortality with a hazard ratio of 1.44 and loss of 6.0 years in life expectancy. Almost two thirds (65%) of the causes of deaths were extra-pulmonary, such as cardiovascular disease, diabetes, cancer and kidney diseases. In addition, COPD was associated with increases in heart rate proportionate to its severity, which led to higher mortality. Participants with COPD who were fully active physically could reduce mortality and have improved heart rates as compared with those without physical activity. In addition, their life expectancy could be extended close to those of the no COPD but inactive cohort. Fully active physical activity can help patients with COPD overcome most of the mortality risks, decrease heart rate, and achieve a life expectancy close to that of patients without COPD. The effectiveness of physical activity on COPD is facilitated by its systemic nature beyond lung disease.

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Motivating patients to exercise

Abstract: The mortality risk of being inactive was equivalent to an increase of around 40 mmHg in SBP or 20 mmHg in DBP, a number relevant to hypertensive patients. Appreciating this relationship may convince the inactive to start exercising, a behavior as important as controlling BP.

Cited by 5 publications

References 28 publications

Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Family member-based supervision of patients with hypertension: a cluster randomized trial in rural China

The ability of physical activity in reducing mortality risks and cardiovascular loading and in extending life expectancy in patients with COPD

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