Determinants of participation and risk factor control according to attendance in cardiac rehabilitation programmes in coronary patients in Europe : EUROASPIRE IV survey

Aim: The purpose of this study was to describe the proportions of patients referred to and attending cardiac rehabilitation programmes in Europe and to compare lifestyle and risk factor targets achieved according to participation in a cardiac rehabilitation programme. Methods: The EUROASPIRE IV cross-sectional survey was undertaken in 78 centres from 24 European countries. Consecutive patients aged <80 years with acute coronary syndromes and/or revascularization procedures were interviewed at least six months after their event. Results: A total of 7998 patients (24% females) were interviewed. Overall, 51% were advised to participate in a cardiac rehabilitation programme and 81% of them attended at least half of the sessions; being 41% of the study population. Older patients, women, those at low socio-economic status or enrolled with percutaneous coronary intervention and unstable angina, as well as those with a previous history of coronary disease, heart failure, hypertension or dysglycaemia were less likely to be advised to follow a cardiac rehabilitation programme. People smoking prior to the recruiting event were less likely to participate. The proportions of patients achieving lifestyle targets were higher in the cardiac rehabilitation programme group as compared to the non-cardiac rehabilitation programme group: stopping smoking (57% vs 47%, p < 0.0001), recommended physical activity levels (47% vs 38%, p < 0.0001) and body mass index<30 kg/m(2) (65% vs 61%, p=0.0007). However, there were no differences in the blood pressure, lipids and glucose control. Patients who attended a cardiac rehabilitation programme had significantly lower anxiety and depression scores and better medication adherence. Conclusions: Only half of all coronary patients were referred and a minority attended a cardiac rehabilitation programme. Those attending were more likely to achieve lifestyle targets, had lower depression and anxiety, and better medication adherence. There is still considerable potential to further reduce cardiovascular risk by increasing uptake and fully integrating secondary prevention and cardiac rehabilitation to provide a modern preventive cardiology programme

Psychosocial work and home stressors predict sickness absence from work

info:eu-repo/semantics/nonPublishe

Assessing physiological response mechanisms and the role of psychosocial job resources in the physical activity health paradox : study protocol for the Flemish Employees' Physical Activity (FEPA) study

Background: In the current labour system many workers are still exposed to heavy physical demands during their job. In contrast to leisure time physical activity (LTPA), occupational physical activity (OPA) is associated with an increased risk of cardiovascular diseases and all-cause mortality, termed the physical activity (PA) health paradox. In order to gain more insight into the PA health paradox, an exploration of structural preventive measures at the workplace is needed and therefore objective field measurements are highly recommended. The objective of this paper is to provide an overview of the protocol of the Flemish Employees' Physical Activity (FEPA) study, including objective measurements of PA, heart rate (HR) and cardiorespiratory fitness (CRF) to gain more insight into the PA health paradox. Methods: A total of 401 workers participated in the FEPA study across seven companies in the service and production sector in Belgium. The participants comprised 167 men and 234 women, aged 20 to 65years. OPA and LTPA were assessed by two Axivity AX3 accelerometers on the thigh and upper back. Ambulatory HR was measured by the Faros eMotion 90 degrees monitor. Both devices were worn during two to four consecutive working days. In addition, CRF was estimated by using the Harvard Step Test. Statistical analyses will be performed using Pearson correlation, and multiple regression adjusted for possible confounders. Discussion: This study aims to provide a better insight in the PA health paradox and the possible buffering factors by using valid and objective measurements of PA and HR (both during LTPA and OPA) over multiple working days. The results of the study can contribute to the prevention of cardiovascular disease by providing tailored recommendations for participants with high levels of OPA and by disseminating the results and recommendations to workplaces, policy makers and occupational health practitioners

Gender differences in the implementation of cardiovascular prevention measures after an acute coronary event

Objective To compare gender-related lifestyle changes and risk factor management after hospitalisation for a coronary event or revascularisation intervention in Europe. Method The EUROASPIRE III survey was carried out in 22 European countries in 2006-2007. Consecutive patients having had a coronary event or revascularisation before the age of 80 were identified. A total of 8966 patients (25.3% women) were interviewed and underwent clinical and biochemical tests at least 6 months after hospital admission. Trends in cardiovascular risk management were assessed on the basis of the 1994-1995, 1999-2000 and 2006-2007 EUROASPIRE surveys. Results Female survey participants were generally older and had a lower educational level than male participants (p<0.0001). The prevalences of obesity (p<0.0001), high blood pressure (BP) (p=0.001), elevated low-density lipoprotein (LDL)-cholesterol (p<0.0001) and diabetes (p<0.0001) were significantly higher in women than in men, whereas current smoking (p<0.0001) was significantly more common in men. The use of antihypertensive and antidiabetic drugs (but not that of other drugs) was more common in women than in men. However, BP (p<0.0001), LDL-cholesterol (p<0.0001) and HbA1c (p<0.0001) targets were less often achieved in women than in men. Between 1994 and 2007, cholesterol control improved less in women than in men (interaction: p=0.009), whereas trends in BP control (p=0.32) and glycaemia (p=0.36) were similar for both genders. Conclusion The EUROASPIRE III results show that despite similarities in medication exposure, women are less likely than men to achieve BP, LDL-cholesterol and HbA1c targets after a coronary event. This gap did not appear to narrow between 1994 and 2007