Impact of lifestyle intervention in cardiovascular prevention: are physical activity advices enough?

Abstract

Background Emotional stress in police officers has been recognized as a modifiable risk factor for cardiovascular disease (CVD). The impact of stress on health, however, is determined by characteristics of the stress stimulus. For example, distinct responses may be induced by acute vs. chronic aversive stimuli. A systematic review of literature has so far not addressed the problem. Methods Studies published in English between January and December 2016 reported by PubMed, Isi Web of Science, CINAHL and PsychInfo were retrieved according to the PRISMA statement. Results The search resulted in 752 records. 16 studies fulfilled the inclusion criteria and were retrieved. The epidemiological design was cross-sectional (12 studies), or longitudinal (4 studies). Studies were of medium (7) or low (9) quality according the Newcastle Ottawa Scale. Small sample size, lack of controls and selection bias were the most common weaknesses. An association between chronic psychosocial stress and the development of CV risk factors was generally supported. In particular, cross-sectional studies supported the association of perceived stress with hypertension, hypertriglyceridemia, and obesity. Studies on work-related stress, however, showed conflicting results. Results were generally inconsistent with regard to definitions and measurement of perceived or work-related stress, features of individual study design, study conduct and conclusions drawn. Conclusions Due to the lack of longitudinal studies, and the heterogeneity of cross-sectional observations, the evidence of the association between stress and CV disease or CV risk factors in police officers is limited. A sound precautionary principle would be to adopt worksite health promotion programs designed to implement stress management strategies and improve the lifestyle and eating habits of this category of workers.

Gender-Specific Clustering of Lifestyle Behaviors and Its Impacts on Cardiovascular Health

“…Moreover, most cardiovascular behavioral interventions in primary care settings have focused on separate interventions to modify single unhealthy behaviors rather than integrated interventions to modify clusters. [65][66][67] A few previous studies have reported that multicomponent interventions, such as being separately intervened to promote a healthy diet, physical activity, smoking, or alcohol intake, showed moderate and less impact on the reduction in cardiovascular biophysical factors or mortality rates among healthy individuals. 68 In this context, multicomponent interventions to improve CVH using behavioral clusters identified in a population may be required.…”

“…Practically, the number of unhealthy lifestyle behaviors may not provide information suitable for developing strategies for cardiovascular behavioral interventions. Moreover, most cardiovascular behavioral interventions in primary care settings have focused on separate interventions to modify single unhealthy behaviors rather than integrated interventions to modify clusters 65–67 . A few previous studies have reported that multicomponent interventions, such as being separately intervened to promote a healthy diet, physical activity, smoking, or alcohol intake, showed moderate and less impact on the reduction in cardiovascular biophysical factors or mortality rates among healthy individuals 68 .…”