Orthostatic stress, sitting, results in adjustments of cardiovascular variables to maintain blood pressure and is prominent in a variety of occupations. Sitting serves as the control position for head-out water immersion studies. This study addressed gender differences in the cardiovascular response to prolonged sitting. Ten men and 10 women had cardiovascular measurements in the supine position compared with measurements during 2 hours in the seated position (Sit). Supine cardiovascular measurements were similar for both sexes. Heart rate changed similarly for both sexes with Sit. With Sit, men had elevated mean arterial pressure (9 +/- 3%), total peripheral resistance (54 +/- 9%), and decreased cardiac index (-27 +/- 5%), while women had no change in mean arterial pressure, lesser elevations in total peripheral resistance (17 +/- 7%), and lesser decreases in cardiac index (-12 +/- 5%) than men. Thus men, compared to women, had an elevated mean arterial pressure response to prolonged orthostatic stress.
on behalf of the Research Team for the Provision of Heart Failure Care Centered on General Practitioners in the Community Background: The purpose of this study was to clarify the current status and issues of community collaboration in heart failure (HF) using a nationwide questionnaire survey.
Methods and Results:We conducted a survey among hospital cardiologists and general practitioners (GPs) using a web-based questionnaire developed with the Delphi method, to assess the quality of community collaboration in HF. We received responses from 46 of the 47 prefectures in Japan, including from 281 hospital cardiologists and 145 GPs. The survey included the following characteristics and issues regarding community collaboration. (1) Hospital cardiologists prioritized medical intervention for preventing HF hospitalization and death whereas GPs prioritized supporting the daily living of patients and their families. (2) Hospital cardiologists have not provided information that meets the needs of GPs, and few regions have a community-based system that allows for the sharing of information about patients with HF. (3) In the transition to home care, there are few opportunities for direct communication between hospitals and community staff, and consultation systems are not well developed.
Conclusions:The current study clarified the real-world status and issues of community collaboration for HF in Japan, especially the differences in priorities for HF management between hospital cardiologists and GPs. Our data will contribute to the future direction and promotion of community collaboration in HF management.
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