المؤلفون: Oreopoulos, Antigone, Fonarow, Gregg C, Ezekowitz, Justin A, McAlister, Finlay A, Sharma, Arya M, Kalantar‐Zadeh, Kamyar, Norris, Colleen M, Johnson, Jeffery A, Padwal, Raj S

المصدر: Congestive Heart Failure. 17(2)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Nutrition and Dietetics, Nutrition, Heart Disease, Obesity, Cardiovascular, Clinical Research, Absorptiometry, Photon, Adipose Tissue, Anthropometry, Body Composition, Body Constitution, Body Mass Index, Body Weight, Cross-Sectional Studies, Female, Heart Failure, Humans, Male, Middle Aged, Waist Circumference, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology

الوصف: How well anthropometric indices such as body mass index (BMI), waist circumference, waist-stature ratio, and waist index correlate with direct measures of body composition (lean body mass, body fat) in men and women with chronic heart failure (CHF) has not been reported. Body composition was assessed by dual-energy x-ray absorptiometry in 140 patients with CHF. Age-adjusted Pearson correlations between each index and measures of body composition for men and women were calculated. Diagnostic accuracy of detecting obesity or high central fat was also examined. In men, all of the anthropometric indices except waist index were just as strongly correlated with lean body mass (correlation coefficients varied between 0.56 for waist-stature ratio to 0.74 for BMI) as with percentage of body fat (correlation coefficients varied between 0.72 for BMI to 0.79 for waist circumference). In women, all 4 anthropometric measures were unable to significantly differentiate between body fat and lean body mass. The positive likelihood ratios for the detection of obesity varied between 2.26 for waist circumference and 3.42 for BMI, waist-stature ratio, and waist index. Anthropometric indices do not accurately reflect body composition in patients with CHF, especially in women. When accurate assessment of body composition is required, direct measurements should be obtained.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/44f6q6qbTest

المؤلفون: Oreopoulos, Antigone, Kalantar-Zadeh, Kamyar, McAlister, Finlay A, Ezekowitz, Justin A, Fonarow, Gregg C, Johnson, Jeffery A, Norris, Colleen M, Padwal, Raj S

المصدر: Journal of cardiac failure. 16(11)

مصطلحات موضوعية: Humans, Cachexia, Absorptiometry, Photon, Spectroscopy, Near-Infrared, Cross-Sectional Studies, Sex Factors, Body Composition, Electric Impedance, Middle Aged, Female, Male, Heart Failure, Bioelectrical impedance analysis, near-Infrared interactance, obesity lean body mass, Absorptiometry, Photon, Spectroscopy, Near-Infrared, Cardiovascular System & Hematology, Clinical Sciences, Cardiorespiratory Medicine and Haematology, Nursing

الوصف: BackgroundWe examined the validity of leg-to-leg bioelectrical impedance analysis (BIA) and near-infrared interactance (NIR) to assess body composition in chronic heart failure (CHF) patients.Methods and resultsA total of 140 patients with CHF were enrolled in this cross-sectional study between June 2008 and July 2009. Dual energy x-ray absorptiometry (DEXA) served as the reference standard. A priori, desired precision levels were set at ± 3.5% body fat and ± 3.5 kg lean body mass. Mean age was 63, 74% were male, and 90% were Caucasian. BIA- and NIR-ascertained percent body fat and lean body mass were highly correlated to DEXA. Mean differences and limits of agreement for NIR were -0.3% ± 5.1% for percent body fat and 2.9 kg ± 4.3 kg for lean body mass. Mean difference and limits of agreement for BIA percent body fat was 0.8% ± 5.8%. BIA lean body mass showed poor agreement with DEXA because of variable limits of agreement across the range of measurement (Pitman's test P < .0001).ConclusionsIn patients with CHF, both NIR and BIA accurately measure body fat. However, both methods were imprecise. NIR overestimated lean body mass and BIA was not useful to assess this parameter. Further study is required, including examination of the utility of these field methods in serially assessing body composition.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/9c15j0z4Test

المؤلفون: Oreopoulos, Antigone, Ezekowitz, Justin A, McAlister, Finlay A, Kalantar-Zadeh, Kamyar, Fonarow, Gregg C, Norris, Colleen M, Johnson, Jeffery A, Padwal, Raj S

المصدر: Mayo Clinic Proceedings. 85(7)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Cardiovascular, Heart Disease, Nutrition, Prevention, Obesity, Absorptiometry, Photon, Adult, Alberta, Analysis of Variance, Bias, Biomarkers, Body Composition, Body Mass Index, C-Reactive Protein, Chronic Disease, Cross-Sectional Studies, Exercise Tolerance, Female, Hand Strength, Heart Failure, Humans, Linear Models, Male, Middle Aged, Natriuretic Peptide, Brain, Nutritional Status, Peptide Fragments, Prealbumin, Predictive Value of Tests, Prognosis, Quality of Life, Risk Factors, Medical and Health Sciences, Biomedical and clinical sciences

الوصف: ObjectiveTo explore the covariate-adjusted associations between body composition (percent body fat and lean body mass) and prognostic factors for mortality in patients with chronic heart failure (CHF) (nutritional status, N-terminal pro-B-type natriuretic peptide [NT-proBNP], quality of life, exercise capacity, and C-reactive protein).Patients and methodsBetween June 2008 and July 2009, we directly measured body composition using dual energy x-ray absorptiometry in 140 patients with systolic and/or diastolic heart failure. We compared body composition and CHF prognostic factors across body fat reference ranges and body mass index (BMI) categories. Multiple linear regression models were created to examine the independent associations between body composition and CHF prognostic factors; we contrasted these with models that used BMI.ResultsUse of BMI misclassified body fat status in 51 patients (41%). Body mass index was correlated with both lean body mass (r=0.72) and percent body fat (r=0.67). Lean body mass significantly increased with increasing BMI but not with percent body fat. Body mass index was significantly associated with lower NT-proBNP and lower exercise capacity. In contrast, higher percent body fat was associated with a higher serum prealbumin level, lower exercise capacity, and increased C-reactive protein level; lean body mass was inversely associated with NT-proBNP and positively associated with hand-grip strength.ConclusionWhen BMI is divided into fat and lean mass components, a higher lean body mass and/or lower fat mass is independently associated with factors that are prognostically advantageous in CHF. Body mass index may not be a good indicator of adiposity and may in fact be a better surrogate for lean body mass in this population.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3j2529sgTest

المؤلفون: Oreopoulos, Antigone, McAlister, Finlay A, Kalantar-Zadeh, Kamyar, Padwal, Raj, Ezekowitz, Justin A, Sharma, Arya M, Kovesdy, Csaba P, Fonarow, Gregg C, Norris, Colleen M

المصدر: European heart journal. 30(21)

مصطلحات موضوعية: Humans, Obesity, Body Mass Index, Risk Factors, Prospective Studies, Aged, Middle Aged, Alberta, Female, Male, Coronary Artery Disease, Coronary disease, Mortality, Epidemiology, Cardiovascular System & Hematology, Cardiorespiratory Medicine and Haematology, Clinical Sciences

الوصف: Aims Our objective was to examine the association between body mass index (BMI) and survival according to the type of treatment in individuals with established coronary artery disease (CAD). Methods and results Patients with CAD were identified in the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry between January 2001 and March 2006. Analyses were conducted separately by treatment strategy [medical management only, percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG)]. Patients were grouped according to six BMI categories. Multivariable-adjusted hazard ratios (HRs) for mortality were calculated using the Cox regression with the referent group for all analyses being normal BMI (18.5-24.9 kg/m(2)). The cohort included 31 021 patients with a median follow-up time of 46 months. In the medically managed only group, BMIs of 25.0-29.9 and 30.0-34.9 kg/m(2) were associated with significantly lower mortality compared with normal BMI patients (adjusted HR 0.72; 95% CI 0.63-0.83 and adjusted HR 0.82; 95% CI 0.69.0-0.98, respectively). In the CABG group, BMI of 30.0-34.9 kg/m(2) had the lowest risk of mortality (adjusted HR 0.75; 95% CI 0.61-0.94), whereas in the PCI group, BMI of 35.0-39.9 kg/m(2) had the lowest risk of mortality (adjusted HR 0.65; 95% CI 0.47-0.90). Patients who were overweight or have mild or moderate obesity were also more likely to undergo revascularization procedures compared with those with normal BMI, despite having lower risk coronary anatomy. Conclusion A paradoxical association between BMI and survival exists in patients with established CAD irrespective of treatment strategy. Patients with obesity may be presenting earlier and receiving more aggressive treatment compared with those with normal BMI.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/5mc2p924Test

المؤلفون: Oreopoulos, Antigone, Padwal, Raj, Kalantar-Zadeh, Kamyar, Fonarow, Gregg C, Norris, Colleen M, McAlister, Finlay A

المصدر: American Heart Journal. 156(1)

مصطلحات موضوعية: Cardiovascular, Prevention, Clinical Research, Nutrition, Heart Disease, Obesity, Clinical Trials and Supportive Activities, Good Health and Well Being, Body Mass Index, Cause of Death, Female, Heart Failure, Humans, Male, Prognosis, Reference Values, Risk Assessment, Survival Analysis, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology

الوصف: BackgroundIn patients with chronic heart failure (CHF), previous studies have reported reduced mortality rates in patients with increased body mass index (BMI). The potentially protective effect of increased BMI in CHF has been termed the obesity paradox or reverse epidemiology. This meta-analysis was conducted to examine the relationship between increased BMI and mortality in patients with CHF.MethodsWe searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Scopus, and Web of Science to identify studies with contemporaneous control groups (cohort, case-control, or randomized controlled trials) that examined the effect of obesity on all-cause and cardiovascular mortality. Two reviewers independently assessed studies for inclusion and performed data extraction.ResultsNine observational studies met final inclusion criteria (total n = 28,209). Mean length of follow-up was 2.7 years. Compared to individuals without elevated BMI levels, both overweight (BMI approximately 25.0-29.9 kg/m(2), RR 0.84, 95% CI 0.79-0.90) and obesity (BMI approximately > or =30 kg/m(2), RR 0.67, 95% CI 0.62-0.73) were associated with lower all-cause mortality. Overweight (RR 0.81, 95% CI 0.72-0.92) and obesity (RR 0.60, 95% CI 0.53-0.69) were also associated with lower cardiovascular mortality. In a risk-adjusted sensitivity analysis, both obesity (adjusted HR 0.88, 95% CI 0.83-0.93) and overweight (adjusted HR 0.93, 95% CI 0.89-0.97) remained protective against mortality.ConclusionsOverweight and obesity were associated with lower all-cause and cardiovascular mortality rates in patients with CHF and were not associated with increased mortality in any study. There is a need for prospective studies to elucidate mechanisms for this relationship.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/84z6x7fsTest

المؤلفون: Oreopoulos, Antigone, Padwal, Raj, Norris, Colleen M, Mullen, John C, Pretorius, Victor, Kalantar‐Zadeh, Kamyar

المصدر: Obesity. 16(2)

مصطلحات موضوعية: Clinical Research, Heart Disease, Nutrition, Heart Disease - Coronary Heart Disease, Atherosclerosis, Prevention, Obesity, Cardiovascular, Oral and gastrointestinal, Metabolic and endocrine, Good Health and Well Being, Aged, Angioplasty, Balloon, Coronary, Coronary Artery Bypass, Female, Hospital Mortality, Humans, Male, Middle Aged, Myocardial Revascularization, Odds Ratio, Risk Factors, Sensitivity and Specificity, Time Factors, Treatment Outcome, Endocrinology & Metabolism

الوصف: ObjectiveOverweight and obesity are often assumed to be risk factors for postprocedural mortality in patients with coronary artery disease (CAD). However, recent studies have described an "obesity paradox" -- a neutral or beneficial association between obesity and mortality postcoronary revascularization. We reviewed the effect of overweight and obesity systematically on short- and long-term all-cause mortality post-coronary artery bypass grafting (CABG) and post-percutaneous coronary intervention (PCI).MethodsWe searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Scopus, and Web of Science to identify cohort, case control, and randomized controlled studies evaluating the effect of obesity on in-hospital/short-term (within 30 days) and long-term (up to 5 years) mortality. Full-text, published articles reporting all-cause mortality between individuals with and without elevated BMI were included. Two reviewers independently assessed studies for inclusion and performed data extraction.ResultsTwenty-two cohort publications were identified, reporting results in ten post-PCI and twelve post-CABG populations. Compared to individuals with non-elevated BMI levels, obese patients undergoing PCI had lower short- (odds ratio (OR) 0.63; 95% confidence interval (CI) 0.54-0.73) and long-term mortality (OR 0.65; 95% CI 0.51-0.83). Post-CABG, obese patients had lower short-term (OR 0.63; 95% CI 0.56-0.71) and similar long-term (OR 0.88; 95% CI 0.60-1.29) mortality risk compared to normal weight individuals. Results were similar in overweight patients for both procedures.ConclusionsCompared to non-obese individuals, overweight and obese patients have similar or lower short- and long-term mortality rates postcoronary revascularization. Further research is needed to confirm the validity of these findings and delineate potential underlying mechanisms.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/75m3g7z6Test

المؤلفون: Le Roux, Carel W., Astrup, Arne, Fujioka, Ken, Greenway, Frank, Lau, David C. W., Van Gaal, Luc, Ortiz, Rafael Violante, Wilding, John P. H., Skjøth, Trine V., Manning, Linda Shapiro, Pi-Sunyer, Xavier, Hamann, Andreas, Barakat, Alain, Blüher, Matthias, Linn, Thomas, Mölle, Andrea, Segner, Alexander, Stübler, Petra, Tosch-Sisting, Regina, Pacini, Furio, Santini, Ferruccio, Marchesini, Giulio, Rotella, Carlo Maria, Invitti, Cecilia, Vettor, Roberto, Buscemi, Silvio, Raya, Pedro Mezquita, Freijoo, Felipe Casanueva, de Barbará, Ramón Gomis, Carraro, Raffaele, Bobillo, Enrique Romero, de la Cuesta, Carmen, Farsang, Csaba, Csaszar, Albert, Zahorska-Markiewicz, Barbara, Pupek-Musialik, Danuta, Franek, Edward, Ostrowska, Lucyna, Olszanecka-Glinianowicz, Magdalena, Lalic, Nebojsa, Micic, Dragan, Ludvik, Bernhard, Paulweber, Bernhard, Prager, Rudolf, Scheen, André, Astrup, Arne Vernon, Hermansen, Kjeld, Madsbad, Sten, Rissanen, Aila, Nieminen, Sakari, Savolainen, Markku, Krempf, Michel, Romon, Monique, Laville, Martine, Marre, Michel, Mira, Reginald, Finucane, Francis, Veenendaal, Aletha, van Berkum, Frank, Johannsson-Vidarsdóttir, Solrun, Van de Walle, Vivienne, Meesters, Eelco, Hjelmesæth, Jøran, Klemsdal, Tor Ole, Kulseng, Bård, Bach-Kliegel, Birgit, Laederach, Kurt, Villiger, Lukas, Golay, Alain, Bilz, Stefan, Sathyapalan, Thozhukat, Bain, Stephen, Kumar, Sudesh, Lean, Michael E. J., McGowan, Barbara, Rehman, Tariq, Wilding, John, Wittert, Gary, Caterson, Ian, Proietto, Joeseph, Prins, John, Neto, Bruno Geloneze, Gross, Jorge Luiz, Chacra, Antonio Roberto, Halpern, Alfredo, de Almeida Suplicy, Henrique, Chow, Francis Chun Chung, Thacker, Hemant P., Chadha, Manoj, Chandalia, Hemaraj, Unnikrishnan, Ambika, Kalra, Sanjay, Deshpande, Neeta, Shunmugavelu, Minakshi, Deshmukh, Vaishali Chetan, Maislos, Maximo, Lieberman, Gabriella Segal, Shimon, Ilan, Stern, Naftali, Nabriski, Dan, Karnieli, Eddy, Shehadeh, Naim, Gonzalez-Galvez, Guillermo, del Rosario Arechavaleta-Granell, Maria, Ortiz, Rafael Margarito Violante, Franco, Guadalupe Morales, Gurieva, Irina, Suplotova, Lyudmila Aleksandrovna, Troshina, Ekaterina, Ruyatkina, Ludmila Aleksandrovna, Voychik, Emma Anatolievna, Martsevich, Sergey, Startseva, Maria A., Seeber, Mary Elizabeth, Badat, Aysha, Ellis, Graham, Altuntas, Yuksel, Guler, Serdar, Ulgen, Ender, Delibasi, Tuncay, Chetty, Tony, Hart, Randy, Janzen, Jeannette, Labonte, Isabelle, Lau, David, Liutkus, Joanne, O'Keefe, Dennis, Padwal, Raj, Ransom, Thomas P. P., Tytus, Richard, Weisnagel, Stanley John, Adler, Jay, Aqua, Keith, Aronoff, Stephen L., Bedel, Gary W., Blevins, Thomas Craig, Blumenau, Joe, Brockmyre, Andrew Peter, Call, Robert S., Canadas, Rafael, Chaykin, Louis B., Cohen, Kenneth, Conrow, Jeffrey Keith, Davis, Matthew G., Downey, H. Jackson, Drosman, Steven Richard, Duckor, Steven, Farmer, H. Frank, Farrell, James, Fehnel, Stephen, Finneran, Matthew Patrick, Forbes, Ray, Forker, Alan, Fredrick, Mark, Geller, Steven Andrew, Gill, Santosh, Glaser, Linda, Greco, Susan Neims, Greenway, Frank Lyons, Harper, Wayne, Herman, Lee, Hoekstra, John, Ingebretsen, Richard, Ison, Rodney, Jain, Rajeev K., Kaplan, Roy, Kaster, Steven Richard, Haase, Gregory A., Kerzner, Boris, Kirstein, Judith Lee, Koltun, William, Krieger, Diane R., Lewis, Cora Elizabeth, Madder, Robert, Marple, Richard N., McDermott, Edward J., Mello, Curtis John, Miller, Alan B., Mullen, Julie, Nardandrea, John, O'Neil, Patrick, Pi-Sunyer, F. Xavier, Pucillo, Ronald M., Rhee, Chanhaeng, Redrick, Scott, Pardini, Aaron, Rothman, Jeffrey, Rubino, Domenica Marie, Sellers, Gladstone, Smith, Timothy, Byars, William David, Soufer, Joseph, Sussman, Allen Michael, Patrick, Kyle, Schramm, Erich Lloyd, Van Cleeff, Martin, Berg, Saul Reuel, Wyatt, Holly Roxanna, Simon, James Alan

المساهمون: Le Roux, Carel W., Astrup, Arne, Fujioka, Ken, Greenway, Frank, Lau, David C. W., Van Gaal, Luc, Ortiz, Rafael Violante, Wilding, John P. H., Skjøth, Trine V., Manning, Linda Shapiro, Pi-Sunyer, Xavier, Hamann, Andrea, Barakat, Alain, Blüher, Matthia, Linn, Thoma, Mölle, Andrea, Segner, Alexander, Stübler, Petra, Tosch-Sisting, Regina, Pacini, Furio, Santini, Ferruccio, Marchesini, Giulio, Rotella, Carlo Maria, Invitti, Cecilia, Vettor, Roberto, Buscemi, Silvio, Raya, Pedro Mezquita, Freijoo, Felipe Casanueva, de Barbará, Ramón Gomi, Carraro, Raffaele, Bobillo, Enrique Romero, de la Cuesta, Carmen, Farsang, Csaba, Csaszar, Albert, Zahorska-Markiewicz, Barbara, Pupek-Musialik, Danuta, Franek, Edward, Ostrowska, Lucyna, Olszanecka-Glinianowicz, Magdalena, Lalic, Nebojsa, Micic, Dragan, Ludvik, Bernhard, Paulweber, Bernhard, Prager, Rudolf, Scheen, André, Astrup, Arne Vernon, Hermansen, Kjeld, Madsbad, Sten, Rissanen, Aila, Nieminen, Sakari, Savolainen, Markku, Krempf, Michel, Romon, Monique, Laville, Martine, Marre, Michel, Mira, Reginald, Finucane, Franci, Veenendaal, Aletha, van Berkum, Frank, Johannsson-Vidarsdóttir, Solrun, Van de Walle, Vivienne, Meesters, Eelco, Hjelmesæth, Jøran, Klemsdal, Tor Ole, Kulseng, Bård, Bach-Kliegel, Birgit, Laederach, Kurt, Villiger, Luka, Golay, Alain, Bilz, Stefan, Sathyapalan, Thozhukat, Bain, Stephen, Kumar, Sudesh, Lean, Michael E. J., Mcgowan, Barbara, Rehman, Tariq, Wilding, John, Wittert, Gary, Caterson, Ian, Proietto, Joeseph, Prins, John, Neto, Bruno Geloneze, Gross, Jorge Luiz, Chacra, Antonio Roberto, Halpern, Alfredo, de Almeida Suplicy, Henrique, Chow, Francis Chun Chung, Thacker, Hemant P., Chadha, Manoj, Chandalia, Hemaraj, Unnikrishnan, Ambika, Kalra, Sanjay, Deshpande, Neeta, Shunmugavelu, Minakshi, Deshmukh, Vaishali Chetan, Maislos, Maximo, Lieberman, Gabriella Segal, Shimon, Ilan, Stern, Naftali, Nabriski, Dan

مصطلحات موضوعية: Adult, Blood Glucose, Body Mass Index, Body Weight, Diabetes Mellitus, Type 2, Double-Blind Method, Female, Glucagon-Like Peptide 1, Glucagon-Like Peptide-1 Receptor, Human, Hypoglycemic Agent, Incretin, Injections, Subcutaneou, Liraglutide, Male, Middle Aged, Obesity, Placebo, Prediabetic State, Risk Reduction Behavior, Treatment Outcome, Weight Loss

وصف الملف: ELETTRONICO

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/28237263; info:eu-repo/semantics/altIdentifier/wos/WOS:000398345100032; volume:389; issue:10077; firstpage:1399; lastpage:1409; numberofpages:11; journal:THE LANCET; http://hdl.handle.net/11577/3280053Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85013371919; http://www.journals.elsevier.com/the-lancetTest/

الإتاحة: https://doi.org/10.1016/S0140-6736Test(17)30069-7
http://hdl.handle.net/11577/3280053Test
http://www.journals.elsevier.com/the-lancetTest/

المؤلفون: Leggett, Laura E., Khadaroo, Rachel G., Holroyd-Leduc, Jayna, Lorenzetti, Diane L., Hanson, Heather, Wagg, Adrian, Padwal, Raj, Clement, Fiona

المصدر: Medicine

مصطلحات موضوعية: Adult, Male, Health Care Rationing, Reproducibility of Results, Surveys and Questionnaires, Chronic Disease, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Health Resources, Humans, Female, Self Report, Systematic Review and Meta-Analysis, Research Article, Aged

الوصف: Supplemental Digital Content is available in the text
A variety of methods may be used to obtain costing data. Although administrative data are most commonly used, the data available in these datasets are often limited. An alternative method of obtaining costing is through self-reported questionnaires. Currently, there are no systematic reviews that summarize self-reported resource utilization instruments from the published literature. The aim of the study was to identify validated self-report healthcare resource use instruments and to map their attributes. A systematic review was conducted. The search identified articles using terms like “healthcare utilization” and “questionnaire.” All abstracts and full texts were considered in duplicate. For inclusion, studies had to assess the validity of a self-reported resource use questionnaire, to report original data, include adult populations, and the questionnaire had to be publically available. Data such as type of resource utilization assessed by each questionnaire, and validation findings were extracted from each study. In all, 2343 unique citations were retrieved; 2297 were excluded during abstract review. Forty-six studies were reviewed in full text, and 15 studies were included in this systematic review. Six assessed resource utilization of patients with chronic conditions; 5 assessed mental health service utilization; 3 assessed resource utilization by a general population; and 1 assessed utilization in older populations. The most frequently measured resources included visits to general practitioners and inpatient stays; nonmedical resources were least frequently measured. Self-reported questionnaires on resource utilization had good agreement with administrative data, although, visits to general practitioners, outpatient days, and nurse visits had poorer agreement. Self-reported questionnaires are a valid method of collecting data on healthcare resource utilization.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::fd52c27c6c6e8437277663f8036cb89aTest
http://europepmc.org/articles/PMC4998854Test

المؤلفون: Khan, Nadia A., Hemmelgarn, Brenda, Herman, Robert J., Bell, Chaim M., Mahon, Jeff L., Leiter, Lawrence A., Rabkin, Simon W., Hill, Michael D., Padwal, Raj, Touyz, Rhian M., Larochelle, Pierre, Feldman, Ross D., Schiffrin, Ernesto L., Campbell, Norman R. C., Moe, Gordon, Prasad, Ramesh, Arnold, Malcolm O., Campbell, Tavis S., Milot, Alain, Stone, James A., Jones, Charlotte, Ogilvie, Richard I., Hamet, Pavel, Fodor, George, Carruthers, George, Burns, Kevin D., Ruzicka, Marcel, deChamplain, Jacques, Pylypchuk, George, Petrella, Robert, Boulanger, Jean-Martin, Trudeau, Luc, Hegele, Robert A., Woo, Vincent, McFarlane, Phil, Vallée, Michel, Howlett, Jonathan, Bacon, Simon L., Lindsay, Patrice, Gilbert, Richard E., Lewanczuk, Richard Z., Tobe, Sheldon, Canadian Hypertension Education Program

المصدر: Department of Medicine Publications

مصطلحات موضوعية: Adult, Aged, Antihypertensive Agents, Blood Pressure Determination, Canada, Case Management, Combined Modality Therapy, Diet, Sodium-Restricted, Female, Health Promotion, Humans, Hypertension, Life Style, Male, Middle Aged, Patient Education as Topic, Prognosis, Program Evaluation, Randomized Controlled Trials as Topic, Treatment Outcome, Cardiology

الوصف: OBJECTIVE: To update the evidence-based recommendations for the prevention and management of hypertension in adults for 2009. OPTIONS AND OUTCOMES: For lifestyle and pharmacological interventions, evidence from randomized controlled trials and systematic reviews of trials was preferentially reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. However, for lifestyle interventions, blood pressure lowering was accepted as a primary outcome given the lack of long-term morbidity and mortality data in this field. Progression of kidney dysfunction was also accepted as a clinically relevant primary outcome among patients with chronic kidney disease. EVIDENCE: A Cochrane collaboration librarian conducted an independent MEDLINE search from 2007 to August 2008 to update the 2008 recommendations. To identify additional published studies, reference lists were reviewed and experts were contacted. All relevant articles were reviewed and appraised independently by both content and methodological experts using prespecified levels of evidence. RECOMMENDATIONS: For lifestyle modifications to prevent and treat hypertension, restrict dietary sodium to less than 2300 mg (100 mmol)/day (and 1500 mg to 2300 mg [65 mmol to 100 mmol]/day in hypertensive patients); perform 30 min to 60 min of aerobic exercise four to seven days per week; maintain a healthy body weight (body mass index 18.5 kg/m(2) to 24.9 kg/m(2)) and waist circumference (smaller than 102 cm for men and smaller than 88 cm for women); limit alcohol consumption to no more than 14 units per week in men or nine units per week in women; follow a diet that is reduced in saturated fat and cholesterol, and that emphasizes fruits, vegetables and low-fat dairy products, dietary and soluble fibre, whole grains and protein from plant sources; and consider stress management in selected individuals with hypertension. For the pharmacological management of hypertension, treatment thresholds and targets should be predicated on by the patient's ...

العلاقة: https://ir.lib.uwo.ca/medpub/25Test; http://www.pulsus.com/journals/abstract.jsp?sCurrPg=abstract&jnlKy=1&atlKy=8801&isuKy=854&isArt=t&fromfoldTest=

الإتاحة: https://ir.lib.uwo.ca/medpub/25Test
http://www.pulsus.com/journals/abstract.jsp?sCurrPg=abstract&jnlKy=1&atlKy=8801&isuKy=854&isArt=t&fromfoldTest=