Promoting Cardiovascular Health

Barnett, Elizabeth D.; Anderson, Tracey; Blosnich, John R.; Halverson, Joel; Novak, Janelle

doi:10.1016/j.amepre.2005.07.036

Cited by 19 publications

(4 citation statements)

References 20 publications

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“…29–31 In 2009, NIH and the Centers for Disease Control and Prevention convened a multidisciplinary workshop to outline the conceptual framework and research needs addressing prevention through the integration of workplace health promotion and health protection (from occupational hazards), 32 which was adopted as a policy statement by AHA. 33 An important workshop theme corroborated by findings from this study is the disproportionate risk factor clustering of some groups of workers employed in the low wage service sector of the labor market, who are often employed by small firms 34 and accrue a disproportionate share of the costs attributed to workrelated fatal and non-fatal injuries and illnesses.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

MacDonald

Bertke

Hein

et al. 2017

American Journal of Preventive Medicine

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Introduction Identification of groups with poor cardiovascular health (CVH) can inform where and how to target public health efforts. National prevalence estimates of CVH were derived for clinical (blood glucose, total cholesterol, blood pressure) and behavioral (BMI, diet quality, physical activity, smoking) factors among U.S. workers aged ≥45 years. Methods This cross-sectional analysis included 6,282 employed black and white men and women aged ≥45 years enrolled in the national population-based REasons for Geographic And Racial Differences in Stroke study from 2003 to 2007. Each CVH factor was scored as ideal (2), intermediate (1), or poor (0) according to American Heart Association criteria, and summed to define optimal composite scores: CVH (sum, 10–14), clinical (sum, 5–6), and behavioral (sum, 6–8) health. Occupational data were collected 2011–2013. Analyses were conducted in 2016. Results Only 14% met ideal criteria for all three clinical health factors, and none met ideal criteria for all four behavioral health factors. Sales and low status office workers had a low prevalence of optimal CVH. Service workers in protective services and the food preparation and serving occupations had a low prevalence of optimal clinical health; computer and healthcare support workers had a low prevalence of optimal behavioral health. Conclusions The prevalence of optimal CVH among middle-aged and older workers in the U.S. is low, but considerable differences exist by occupation. Targeted public health interventions may improve the CVH of at-risk older workers with different clinical and behavioral risk factor profiles employed in diverse occupational settings.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

MacDonald

Bertke

Hein

et al. 2017

American Journal of Preventive Medicine

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“…Participants randomized to the PREVENT group engaged in a multi-modal, case-managed program of exercise and education. Because the intervention was behavior-focused, strategies known to facilitate and sustain behavior change were incorporated [33][34][35] : (i) meetings of participants and program providers to identify personal health goals, and related barriers and facilitators, (ii) exercise sessions supervised by health professionals, (iii) user-friendly health passports to record exercise schedule, medication regimen, and vascular risk factors, (iv) positive reinforcement, and (v) adult learning strategies (interactive educational sessions with participant involvement in content selection). Based on our previous exercise trials, we set a priori targets for adherence in attending exercise and education sessions: attending at least 75% of the total number of exercise sessions and at least 75% of the total number of education sessions.…”

Section: Prevent Interventionmentioning

confidence: 99%

Program of Rehabilitative Exercise and Education to Avert Vascular Events After Non-Disabling Stroke or Transient Ischemic Attack (PREVENT Trial): A Randomized Controlled Trial

MacKay-Lyons

Gubitz

Phillips

et al. 2021

Neurorehabil Neural Repair

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Background Non-disabling stroke (NDS) and transient ischemic attack (TIA) herald the possibility of future, more debilitating vascular events. Evidence is conflicting about potency of exercise and education in reducing risk factors for second stroke. Methods Three-site, single-blinded, randomized controlled trial with 184 participants <3 months of NDS or TIA (mean age, 65 years; 66% male) randomized to usual care (UC) or UC + 12-week program of exercise and education (PREVENT). Primary (resting systolic blood pressure) and secondary outcomes (diastolic blood pressure [DBPrest], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC], TC/HDL, triglycerides, fasting glucose, and body mass index) were assessed at baseline, post-intervention, and 6- and 12-month follow-up. Peak oxygen consumption (VO2peak) was measured at baseline, post-intervention, 12-month assessments. Results Significant between-group differences at post-intervention favored PREVENT group over UC: DBPrest (mean difference [MD]: −3.2 mmHg, 95% confidence interval [CI]: −6.3, −.2, P = .04) and LDL-C (MD: −.31 mmol/L, 95% CI: −.42, −.20, P = .02). Trends of improvement in PREVENT group were noted in several variables between baseline and 6-month follow-up but not sustained at 12-month follow-up. Of note, VO2 peak did not change over time in either group. Conclusion Impact of PREVENT on vascular risk factor reduction was more modest than anticipated, possibly because several outcome variables approximated normative values at baseline and training intensity may have been sub-optimal. Further investigation is warranted to determine when exercise and education programs are viable adjuncts to pharmaceutical management for reduction of risk factors for second stroke. Clinical Trial Registration-URL: http://www.clinicaltrials.gov . Unique identifier: #NCT00885456

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“…Because this intervention is behavior-focused (e.g., encouraging daily physical activity, health eating, smoking cessation, medication use adherence), several strategies known to facilitate and sustain behavioral change have been incorporated into the design [79,80]:…”

Section: Methodsmentioning

confidence: 99%

Program of rehabilitative exercise and education to avert vascular events after non-disabling stroke or transient ischemic attack (PREVENT Trial): a multi-centred, randomised controlled trial

et al. 2010

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BackgroundDespite lack of outward signs, most individuals after non-disabling stroke (NDS) and transient ischemic attack (TIA) have significant cardiovascular and cerebrovascular disease and are at high risk of a major stroke, hospitalization for other vascular events, or death. Most have multiple modifiable risk factors (e.g., hypertension, physical inactivity, hyperlipidaemia, diabetes, tobacco consumption, psychological stress). In addition, accelerated rates of depression, cognitive decline, and poor quality of sleep have been reported following TIA, which correlate with poor functional outcomes and reduced quality of life. Thus, NSD and TIA are important warning signs that should not be overlooked. The challenge is not unlike that facing other 'silent' conditions - to identify a model of care that is effective in changing people's current behaviors in order to avert further morbidity.Methods/DesignA single blind, randomized controlled trial will be conducted at two sites to compare the effectiveness of a program of rehabilitative exercise and education versus usual care in modifying vascular risk factors in adults after NDS/TIA. 250 adults within 90 days of being diagnosed with NDS/TIA will be randomly allocated to a 12-week program of exercise and education (PREVENT) or to an outpatient clinic assessment and discussion of secondary prevention recommendations with return clinic visits as indicated (USUAL CARE). Primary outcome measures will include blood pressure, waist circumference, 12-hour fasting lipid profile, and 12-hour fasting glucose/hemoglobin A1c. Secondary measures will include exercise capacity, walking endurance, physical activity, cognitive function, depression, goal attainment and health-related quality of life. Outcome assessment will be conducted at baseline, post-intervention, and 6- and 12-month follow-ups. Direct health care costs incurred over one year by PREVENT versus USUAL CARE participants will also be compared. Ethical approval for the trial has been obtained from the relevant Human Research Ethics Boards.DiscussionWhether timely delivery of an adapted cardiac rehabilitation model is effective in attaining and maintaining vascular risk reduction targets in adults after NDS/TIA is not yet known. We anticipate that the findings of this trial will make a meaningful contribution to the knowledge base regarding secondary stroke prevention.Trial registrationThis trial is registered with the Clinical Trials.gov Registry (NCT00885456).

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Promoting Cardiovascular Health

Cited by 19 publications

References 20 publications

Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

Program of Rehabilitative Exercise and Education to Avert Vascular Events After Non-Disabling Stroke or Transient Ischemic Attack (PREVENT Trial): A Randomized Controlled Trial

Program of rehabilitative exercise and education to avert vascular events after non-disabling stroke or transient ischemic attack (PREVENT Trial): a multi-centred, randomised controlled trial

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