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Adult obesity and number of years lived with and without cardiovascular disease / M.C. Pardo Silva in Obesity, 14(2006)7 ([07/01/2006])  

[article] Adult obesity and number of years lived with and without cardiovascular disease [printed text] / M.C. Pardo Silva, Author ; Chris De Laet , Author ; W.J. Nusselder, Author ; A.A. Mamun, Author ; A. Peeters, Author . - 2006 . - 1264-73. Languages : English (eng) in Obesity > 14(2006)7 [07/01/2006] . - 1264-73 Descriptors: Classification W 1 Serials. Periodicals Indexation Aging ; Body Mass Index ; Cardiovascular diseases ; Cost of Illness ; Female ; Humans ; Journal Article ; Life Expectancy ; Male ; Middle Aged ; Myocardial infarction ; Obesity ; Overweight ; Peer Review ; Risk Assessment ; Risk Factors ; Stroke ; Time Factors ; United States Abstract: OBJECTIVE: To determine the differences in number of years lived free of cardiovascular disease (CVD) and number of years lived with CVD between men and women who were obese, pre-obese, or normal weight at 45 years of age. RESEARCH METHODS AND PROCEDURES: We constructed multistate life tables for CVD, myocardial infarction, and stroke, using data from 2551 enrollees (1130 men) in the Framingham Heart Study who were 45 years of age. RESULTS: Obesity and pre-obesity were associated with fewer number of years free of CVD, myocardial infarction, and stroke and an increase in the number of years lived with these diseases. Forty-five-year-old obese men with no CVD survived 6.0 years [95% confidence interval (CI), 4.1; 8.1] fewer than their normal weight counterparts, whereas, for women, the difference between obese and normal weight subjects was 8.4 years (95% CI: 6.2; 10.8). Obese men and women lived with CVD 2.7 (95% CI: 1.0; 4.4) and 1.4 years (95% CI: -0.3; 3.2) longer, respectively, than normal weight individuals. DISCUSSION: In addition to reducing life expectancy, obesity before middle age is associated with a reduction in the number of years lived free of CVD and an increase in the number of years lived with CVD. Such information is paramount for preventive and therapeutic decision-making by individuals and practitioners alike. Link for e-copy: http://www.nature.com/oby/journal/v14/n7/pdf/oby2006144a.pdf Format of e-copy: PDF [Open Access] (Embargo 2 years) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2154 [article]

Physical activity and life expectancy with and without diabetes / J.T. Jonker in Diabetes Care, 29(2006)1 ([01/01/2006])  

[article] Physical activity and life expectancy with and without diabetes : life table analysis of the Framingham Heart Study [printed text] / J.T. Jonker, Author ; Chris De Laet , Author ; O.H. Franco, Author ; A. Peeters, Author ; Johan Mackenbach, Author ; W.J. Nusselder, Author . - 2006 . - 38-43. Languages : English (eng) in Diabetes Care > 29(2006)1 [01/01/2006] . - 38-43 Descriptors: Classification W 1 Serials. Periodicals Indexation Adult ; Body Mass Index ; Diabetes Mellitus ; Female ; Humans ; Journal Article ; Life Expectancy ; Life Style ; Male ; Massachusetts ; Middle Aged ; Motor Activity ; Peer Review ; Physical Fitness ; Population Surveillance ; Smoking ; United States Abstract: OBJECTIVE: Physical activity is associated with a reduced risk of developing diabetes and with reduced mortality among diabetic patients. However, the effects of physical activity on the number of years lived with and without diabetes are unclear. Our aim is to calculate the differences in life expectancy with and without type 2 diabetes associated with different levels of physical activity. RESEARCH DESIGN AND METHODS: Using data from the Framingham Heart Study, we constructed multistate life tables starting at age 50 years for men and women. Transition rates by level of physical activity were derived for three transitions: nondiabetic to death, nondiabetic to diabetes, and diabetes to death. We used hazard ratios associated with different physical activity levels after adjustment for age, sex, and potential confounders. RESULTS: For men and women with moderate physical activity, life expectancy without diabetes at age 50 years was 2.3 (95% CI 1.2-3.4) years longer than for subjects in the low physical activity group. For men and women with high physical activity, these differences were 4.2 (2.9-5.5) and 4.0 (2.8-5.1) years, respectively. Life expectancy with diabetes was 0.5 (-1.0 to 0.0) and 0.6 (-1.1 to -0.1) years less for moderately active men and women compared with their sedentary counterparts. For high activity, these differences were 0.1 (-0.7 to 0.5) and 0.2 (-0.8 to 0.3) years, respectively. CONCLUSIONS: Moderately and highly active people have a longer total life expectancy and live more years free of diabetes than their sedentary counterparts but do not spend more years with diabetes. Link for e-copy: http://vdic.idm.oclc.org/login?url=http://care.diabetesjournals.org/content/29/1 [...] Format of e-copy: VDIC IP recognition Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2156 [article]

Primary prevention of cardiovascular disease / O.H. Franco in International Journal of Technology Assessment in Health Care, 23(2007)1 ([04/01/2007])  

[article] Primary prevention of cardiovascular disease : cost-effectiveness comparison [printed text] / O.H. Franco, Author ; A.J. der Kinderen, Author ; Chris De Laet , Author ; A. Peeters, Author ; Luc Bonneux, Author . - 2007 . - 71-9. Languages : English (eng) in International Journal of Technology Assessment in Health Care > 23(2007)1 [04/01/2007] . - 71-9 Descriptors: Classification W 1 Serials. Periodicals Indexation Adult ; Aged ; Cardiovascular diseases ; Cohort Studies ; Cost-Benefit Analysis ; Female ; Great Britain ; Humans ; Journal Article ; Male ; Middle Aged ; Peer Review ; Primary Prevention Abstract: OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of four risk-lowering interventions (smoking cessation, antihypertensives, aspirin, and statins) in primary prevention of cardiovascular disease. METHODS: Using data from the Framingham Heart Study and the Framingham Offspring study, we built life tables to model the benefits of the selected interventions. Participants were classified by age and level of risk of coronary heart disease. The effects of risk reduction are obtained as numbers of death averted and life-years saved within a 10-year period. Estimates of risk reduction by the interventions were obtained from meta-analyses and costs from Dutch sources. RESULTS: The most cost-effective is smoking cessation therapy, representing savings in all situations. Aspirin is the second most cost-effective (euro 2,263 to euro 16,949 per year of life saved) followed by antihypertensives. Statins are the least cost-effective (euro 73,971 to euro 190,276 per year of life saved). CONCLUSIONS: A cost-effective strategy should offer smoking cessation for smokers and aspirin for moderate and high levels of risk among men 45 years of age and older. Statin therapy is the most expensive option in primary prevention at levels of 10-year coronary heart disease risk below 30 percent and should not constitute the first choice of treatment in these populations. Link for e-copy: http://journals.cambridge.org/action/displayFulltext?type=1&fid=651516&jid=THC&v [...] Format of e-copy: VDIC IP recognition Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2150 [article]