Factors associated with return to work following myocardial infarction: A systematic review of observational studies.

OBJECTIVES: To identify and critically synthesise literature on return to work of patients following a myocardial infarction and to identify factors that are associated with this. BACKGROUND: Understanding when patients return to work after myocardial infarction and what factors are associated with this may be helpful in designing person-centred treatment plans to facilitate patients' rehabilitation and return to work. DESIGN: A narrative systematic review. REVIEW METHODS: Six databases, MEDLINE, CINAHL, Academic Search Complete, EMBASE, SCOPUS and ProQuest Health and Medicine, and the search engine Google were searched to retrieve peer-reviewed articles published in English from January 2008-January 2020. In total, 22,217 papers were sourced and screened, with 18 papers retained for quality appraisal using the Joanna Briggs Institute Critical Appraisal Tools. RESULTS: The mean time to return to work varied between 46-192 days; about half the participants resumed work by 3 months. Patients who were male, younger, educated, non-manual workers or owned their own business, and those who evaluated their general and mental health highly, and had shorter hospitalisation, fewer comorbidities, complications and mental health issues were more likely to return to work after myocardial infarction. RELEVANCE TO CLINICAL PRACTICE: Findings may help nurses detect patients at increased risk of failure to return to work and provide appropriate support to facilitate this.

Hypertensive Disorders of Pregnancy and Risk of Future Cardiovascular Disease in Women.

Cardiovascular disease continues to be the leading cause of mortality in women globally. In addition to traditional risk factors, some sex-specific conditions increase the burden of cardiovascular disease in women. With this literature review, we aimed to review evidence on associations between hypertensive disorders of pregnancy and risk of cardiovascular disease in later life. After a database search and application of inclusion and exclusion criteria, 11 studies were included in the review. Our findings suggest that a history of preeclampsia, gestational hypertension, or elevated systolic blood pressure alone during pregnancy is consistently associated with increased risk of developing and dying from myocardial infarction, heart failure, hypertension, and/or stroke in later life. Nurses and other health care providers should be aware of the cardiovascular risk associated with hypertensive disorders of pregnancy and engage women at risk in discussions about health promotion strategies and interventions to address modifiable cardiovascular disease risk factors.

Assessment and detection of depression in patients with coronary artery disease: validation of the Persian version of the PHQ-9.

Background: Depression is a common comorbidity in patients with coronary artery disease (CAD), which often remains undetected and untreated. Objective: This study aimed to examine the psychometric properties of the Depression Module of the Patient Health Questionnaire (PHQ-9) on a sample of cardiac patients in Iran. Method: The Persian version of the PHQ-9 was developed and administered to 150 patients with CAD, admitted to a tertiary hospital in Tehran, Iran. The major depression module of the International Neuropsychiatric Interview (MINI) was used as the gold standard for the diagnosis of depression. Results: The Persian PHQ-9 demonstrated acceptable internal consistency, with Cronbach's alpha coefficient of 0.80. The optimal cut-off score of ≥7 showed a sensitivity of 76, specificity of 78, and the area under curve of 0.82. Conclusion: The Persian PHQ-9 has acceptable psychometric properties to screen for and detect a current depressive episode in patients with CAD, with recommended cut-off score of ≥7.

The Effect of Green Tea Ingestion and Interval Sprinting Exercise on the Body Composition of Overweight Males: A Randomized Trial.

The combined effect of green tea ingestion and interval sprinting exercise on body and abdominal fat of overweight males was investigated. Participants were randomly assigned into control (C), green tea (GT), interval sprinting exercise (ISE), and green tea and ISE (GT + ISE) groups. The GT, GT + ISE, and C groups consumed three GT capsules daily. The ISE and GT + ISE groups completed 36 ISE sessions over 12 weeks. Forty eight overweight males with a mean BMI of 28.5 ± 0.92 kg/m² and age of 26 ± 0.7 years acted as participants. There was a significant reduction in total and abdominal fat mass for the ISE and GT + ISE groups, p < 0.05, however, total and abdominal fat mass did not significantly change in the GT and C groups. There was a significant increase in total lean mass, p < 0.05, after the intervention for the ISE and GT + ISE groups only. There was a significant increase in fat oxidation during submaximal aerobic exercise, p < 0.05, after the intervention for the ISE, GT + ISE, and GT groups with no change for the C group. Following the 12-week intervention the ISE and GT + ISE groups, compared to C, recorded a significantly greater decrease in body and abdominal fat, and a significant increase in total lean mass. Ingestion of green tea by itself, however, did not result in a significant decrease in body or abdominal fat, but increased fat utilization during submaximal exercise. The combination of 12 weeks of GT ingestion and ISE did not result in greater total and abdominal fat reduction compared to 12 weeks of ISE alone.

Heart Disease and Depression: Is Culture a Factor?

PURPOSE: This article seeks to review and discuss the evidence linking depression, coronary heart disease (CHD), and culture. METHOD: PsychInfo, CINAHL, PubMed, and Google were searched for pertinent evidence linking depression, culture, and CHD, and retrieved articles were analyzed using thematic content analysis. FINDINGS: Identified themes were the followings: depression is a factor in development and prognosis of CHD and affects the capacity to self-manage and adhere to treatment recommendations; culture mediates mental health/illness representations and treatment-seeking behaviors; screening and assessment of depression can be affected by cultural factors; and there is a need for culturally appropriate screening and therapeutic strategies. DISCUSSION AND CONCLUSIONS: As depression is a predictor and moderating variable in the genesis and progression of CHD, understanding how factors such as culture affect screening and management of the disease is important to inform the development of culturally and linguistically competent strategies that ensure accurate screening, detection, and treatment of depression in cardiac patients in clinical practice.

Rating of perceived exertion after 12 weeks of high-intensity, intermittent sprinting.

The effect of a 12-week high-intensity intermittent exercise (HIIE) intervention on the rating of perceived exertion (RPE) response of young males was examined. Participants (N = 38; M BMI = 28.7 kg x m(-2), SD = 3.1; M age = 24.9 yr., SD = 4.3) were randomly assigned to either an exercise or control group. The exercise group received HIIE three times per week, 20 min. per session, for 12 weeks. RPE was assessed before and after HIIE training and during pre- and post-maximal oxygen uptake (VO2 max) testing. After HIIE training, RPE was significantly higher in Weeks 11-12 compared to Weeks 1-2. In contrast, heart rate was similar throughout training. Comparing post- to pre-VO2 max test, RPE was significantly lower in the exercise group, whereas for controls, RPE was similar. Aerobic power improved 15% for the exercise group, with no significant change for controls. HIIE resulted in significant increases in RPE, whereas RPE during the VO2 max test was significantly decreased.

High-intensity intermittent exercise and cardiovascular and autonomic function.

OBJECTIVE: The effect of 12 weeks of high-intensity intermittent exercise (HIIE) on cardiac, vascular, and autonomic function of young males was examined. METHODS: Thirty-eight young men with a BMI of 28.7 ± 3.1 kg m(-2) and age 24.9 ± 4.3 years were randomly assigned to either an HIIE or control group. The exercise group underwent HIIE three times per week, 20 min per session, for 12 weeks. Aerobic power and a range of cardiac, vascular, and autonomic measures were recorded before and after the exercise intervention. RESULTS: The exercise, compared to the control group, recorded a significant reduction in heart rate accompanied by an increase in stroke volume. For the exercise group forearm vasodilatory capacity was significantly enhanced, P < 0.05. Arterial stiffness, determined by pulse wave velocity and augmentation index, was also significantly improved, after the 12-week intervention. For the exercise group, heart period variability (low- and high-frequency power) and baroreceptor sensitivity were significantly increased. CONCLUSION: High-intensity intermittent exercise induced significant cardiac, vascular, and autonomic improvements after 12 weeks of training.

The effects of high-intensity intermittent exercise training on cardiovascular response to mental and physical challenge.

The purpose was to examine the effect of a 12-week exercise intervention on the cardiovascular and autonomic response of males to mental and physical challenge. Thirty four young overweight males were randomly assigned to either an exercise or control group. The exercise group completed a high-intensity intermittent exercise (HIIE) program three times per week for 12weeks. Cardiovascular response to the Stroop task was determined before and after the intervention by assessing heart rate (HR), stroke volume (SV), arterial stiffness, baroreflex sensitivity (BRS), and skeletal muscle blood flow. The exercise group improved their aerobic fitness levels by 17% and reduced their body weight by 1.6kg. Exercisers compared to controls experienced a significant reduction in HR (p<0.001) and a significant increase in SV (p<0.001) at rest and during Stroop and exercise. For exercisers, arterial stiffness significantly decreased at rest and during Stroop (p<0.01), whereas BRS was increased at rest and during Stroop (p<0.01). Forearm blood flow was significantly increased during the first two minutes of Stroop (p<0.05). HIIE induced significant cardiovascular and autonomic changes at rest and during mental and physical challenge after 12weeks of training.

A description of gender differences in angiographic findings in a single-center Iranian hospital.

Coronary angiography is one of the most common hospital procedures, though there is limited information on the location and extent of coronary artery blockages other than for predominately White patients. This study examined the location and magnitude of coronary artery blockages in patients admitted to a leading tertiary heart hospital in Iran with symptoms of coronary artery disease (CAD). This retrospective descriptive study aimed to review angiography records of all patients with symptoms of CAD undergone diagnostic coronary angiography between February 2002 and September 2004. A total of 94 consecutive angiographic records were analyzed to determine the culprit coronary arteries and the severity of CAD. The findings of the study showed that double- vessel disease was the commonest type of CAD. The left anterior descending (LAD) artery was the most common culprit artery (84%), followed by RCA (64%), CX (37%), OM (13%) and LMS (3%). Our study showed a relatively high angiographic prevalence of LAD blockages. The results of this study provide additional support for the significance of ethnicity in the extent of coronary artery blockages.