ABSTRACT
Given the aging global population, identifying heart failure (HF) phenotypes has become crucial, as distinct disease characteristics can influence treatment and prognosis in older adults. This study aimed to analyze the association between clustering of cardiovascular risk factors and HF in older adults. A cross-sectional epidemiological study was conducted with 1322 older adults (55% women, mean age 70.4) seen in primary health care. Diagnosis of HF was performed by a cardiologist based on diagnostic tests and medical history. Cardiovascular risk factors included hypertension, diabetes, hypercholesterolemia, and smoking. Using logistic regression, potential associations were tested. Individual risk factor analysis showed that older adults with hypertension, diabetes, or hypercholesterolemia had up to 7.6 times higher odds to have HF. The cluster where older adults had only one risk factor instead of none increased the odds of HF by 53.0%. Additionally, the odds of older patients having HF ranged from 3.59 times for the two-risk factor cluster to 20.61 times for the simultaneous presence of all four factors. The analysis of clusters substantially increasing HF risk in older adults revealed the importance of individualizing subgroups with distinct HF pathophysiologies. The clinical significance of these clusters can be beneficial in guiding a more personalized therapeutic approach.
ABSTRACT
Only a small proportion of Brazilian adolescents practice sufficient physical activity (PA). However, it is not clear whether this proportion has been decreasing over time. This study aimed to examine the 10-year trends of sufficient PA in adolescents and to investigate differences by sex and age. Using a standard protocol, we compared two cross-sectional cohorts of adolescents aged 15 to 18 years, recruited in 2007 (n = 1040) and in 2017/18 (n = 978). Using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the adolescents reported moderate-to-vigorous PA (MVPA) performed in the last seven days. Sufficient PA was defined as engaging in at least 60 min/day of MVPA. In the subgroups, investigated by sex or age, there was an increase in the prevalence of sufficient PA. Overall, sufficient PA declined by 28.1% from 2007 to 2017/18. Boys in 2007 were more active than their 2017/18 peers, and this was equally observed in girls in 2007 compared to those in 2017/18. The findings show decreasing secular trends in sufficient PA in the investigated adolescents. Not only are public health authorities in Brazil witnessing an escalation of insufficient PA, but they are also losing ground with the most active adolescents.
Subject(s)
Exercise , Male , Female , Humans , Adolescent , Brazil , Cross-Sectional Studies , PrevalenceABSTRACT
Physical fitness (PF) is considered an excellent biomarker of health. One possible strategy to improve PF levels is active commuting. This review, performed accordingly to the Preferred Reporting Items for Systematic Reviews guidelines includes scientific articles published in peer-reviewed journals up to December 2019 that aim at examining the relationship between active travel/commuting and PF. The search was performed in three databases (PubMed, Scopus, and Web of Science). Sixteen studies were included in this review. Findings from the 16 studies were unclear. From the eleven studies on children and adolescents screened, eight were cross-sectional, one prospective cohort, one quasi-experimental, and one experimental. From the five studies on adults, four were experimental and one cross-sectional. Body mass, waist circumference, skinfolds, fat mass, cardiorespiratory fitness, upper and lower strength tests were performed in children, adolescents, and adults. Agility and speed tests were performed only in the young age groups. Majority of the investigations on young ages and adults have shown positive effects or relationships between active commuting and several attributes of PF. However, to avoid misconceptions, there is a need for future robust investigation to identify potential mediators or confounders in this relationship. More robust investigations are essential to understand how and whether decision-makers and public health authorities can use active travel/commuting as a strategy to improve PF in all ages.
Subject(s)
Bicycling , Physical Fitness , Transportation , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Cross-Sectional Studies , Female , Hand Strength , Humans , Male , Middle Aged , Occupations , Prospective Studies , Travel , Walking , Young AdultABSTRACT
O objetivo deste estudo foianalisar a concordância entre dois critérios de classificação da atividade física (AF) e os respectivos fatores associados. Os participantes foram 2.517 adolescentes amazonenses (14 a 19 anos de idade). O nível de AF e as variáveis independentes (sexo, faixa etária, ano escolar, turno de estudo, renda familiar, escolaridade materna e situação ocupacional) foram coletados por meio de questionário. O coeficiente kappa e a regressão logística binária foram empregados, respectivamente, para analisar a concordância entre as prevalências e os fatores associados aos dois critérios de classificação da AF (300 e 420 minutos/semana). Verificou-se moderada concordância entre os critérios (kappa = 0,58; p< 0,001) para classificação do nível de AF, com diferença de 8,5 pontos percentuais entre as prevalências, sendo que para os 300 e 420 minutos/semana foram classificados como fisicamente ativos 15,5% (IC95% = 14,2-16,7) e 7,0% (IC95% = 6,0-7,0) dos participantes, respectivamente. Os adolescentes do sexo masculino e os que não trabalhavam tiveram mais chances de serem fisicamente ativos em ambos os critérios. Os adolescentes mais novos (14 a 16 anos) tiveram mais chances de serem fisicamente ativos no critério de 300 minutos/semana. O ano escolar, turno de estudo, renda familiar e escolaridade materna não se associaram aos critérios utilizados. A concordância entre os dois critérios de classificação do nível de AF foi moderada e os fatores associados foram semelhantes em ambos os critérios, com exceção da faixa etária.
This study aimed to analyze the agreement between two criteria to classify physical activity (PA), and the respective associated factors.Participants were 2.517 adolescents (aged 14 to 19) from Amazonas. The PA level and the independent variables (sex, age group, school year, school shift, family income, maternal educational level and work) were collected by means of a questionnaire. The kappa coefficient and binary logistic regression were used to analyze the agreement between the prevalence and the associated factors to both criteria (300 and 420 minutes/week of PA), respectively. We found a moderate agreement between the two criteria to classify PA level (kappa = 0.58), with a difference of 8.5 percentage points between the prevalence, considering that for 300 and 420 minutes/week, 15.5% (95%CI = 14.2-16.7) and 7.0% (95%CI = 6.0-7.0) of the participants were classified as physically active, respectively. Male adolescents and those who did not work were more likely to be physically active in both criteria, compared to their peers. Younger adolescents (14 to 16 years) were more likely to be physically active in the criterion of 300 minutes/week. School year, school shift, family income and maternal educational level were not associated to the used criteria. In conclusion, the agreement between two criteria to classify PA level was moderated and the associated factors to sufficient PA were similar in both criteria with an exception for age group.
