Handbook of cardiovascular behavioral medicine

Cardiovascular disease is the leading cause of morbidity and mortality in the United States and worldwide. It is well recognized that traditional risk factors for cardiovascular disease have limited predictive utility in the identification of new cardiovascular disease cases and outcomes. Thus, investigators have argued that application of a biopsychosocial research paradigm in this field may be of particular utility in understanding cardiovascular disease pathogenesis. Accordingly, a subdiscipline within the field of behavioral medicine – cardiovascular behavioral medicine – examines interrelations among biological, behavioral, psychological, social, and environmental factors in cardiovascular health and disease

Classification of cardiovascular diseases: Epidemiology, diagnosis, and treatment

This chapter reviews the main cardiovascular diseases (CVD) that are common in clinical practice and have received substantial attention from researchers in behavioral medicine and related disciplines. A concise overview is provided for hypertension, ischemic heart disease, cardiomyopathies, heart failure, cardiac arrhythmias, and stroke. For each CVD, we present information about disease characteristics, epidemiology, diagnostic tools, disease mechanisms, and treatment options. This chapter concludes with a general discussion of how these CVD features are relevant to research in cardiovascular behavioral medicine

Relation of weight gain and weight loss on subsequent diabetes risk in overweight adults

STUDY OBJECTIVE—To determine whether long term weight gain and weight loss are associated with subsequent risk of type 2 diabetes in overweight, non-diabetic adults.
DESIGN—Prospective cohort. Baseline overweight was defined as BMI⩾27.3 for women and BMI⩾27.8 for men. Annual weight change (kg/year) over 10 years was calculated using measured weight at subjects' baseline and first follow up examinations. In the 10 years after measurement of weight change, incident cases of diabetes were ascertained by self report, hospital discharge records, and death certificates.
SETTING—Community.
PARTICIPANTS—1929 overweight, non-diabetic adults.
MAIN RESULTS—Incident diabetes was ascertained in 251 subjects. Age adjusted cumulative incidence increased from 9.6% for BMI<29 to 26.2% for BMI⩾37. Annual weight change over 10 years was higher in subjects who become diabetic compared with those who did not for all BMI<35. Relative to overweight people with stable weight, each kg of weight gained annually over 10 years was associated with a 49% increase in risk of developing diabetes in the subsequent 10 years. Each kg of weight lost annually over 10 years was associated with a 33% lower risk of diabetes in the subsequent 10( )years.
CONCLUSIONS—Weight gain was associated with substantially increased risk of diabetes among overweight adults, and even modest weight loss was associated with significantly reduced diabetes risk. Minor weight reductions may have major beneficial effects on subsequent diabetes risk in overweight adults at high risk of developing diabetes. 


Keywords: obesity; diabete