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Background: Comprehensive cardiac rehabilitation (CR) is a process designed to restore full physical, psychological and social activity and to reduce cardiovascular risk factors. Fear of movement may contribute to the occurrence and intensification of hypokinesia, and consequently affect the effectiveness of therapy. The aim of the study was to determine the level of barriers of physical activity in patients undergoing cardiac rehabilitation. The relationship between selected determinants (age and health selfassessment) and the kinesiophobia level were also examined. Material/Methods: 115 people aged 40-84 years were examined: 50 females (x = 63.46; SD = 11.19) and 65 males (x = 64.65; SD = 10.59) – patients undergoing cardiac rehabilitation at the Upper-Silesian Medical Centre in Katowice. In the present study, the Polish version of questionnaires: Kinesiophobia Causes Scale (KCS) and Short Form Health Survey (SF-36) were used. Questionnaires were supplemented by authors’ short survey. Results: The patients presented an elevated level of kinesiophobia, both in general as well as in individual components. In women, the kinesiophobia level was higher than in men. The psychological domain was a greater barrier of physical activity than the biological one. Strong, negative correlations of psychological and biological domains of kinesiophobia to physical functioning (SF-36) were noted in women. In the case of men, correlations were weaker, but also statistically significant. Conclusions: 1. Sex differentiates patients in their kinesiophobia level 2. Poor self-assessment of health is associated with a greater intensification of kinesiophobia 3. A high level of kinesiophobia may negatively affect cardiac rehabilitation process
Introduction. Elevated uric acid (UA) is associated with arterial hypertension (AH), obesity, dyslipidemia and insulin resistance. However, its association with body components has not been previously investigated. Objective. The aim of this study was to evaluate the relationship between UA and cardiovascular risk factors, anthropometric parameters and body composition in patients with AH. Materials and method. In 138 patients with AH the following parameters were evaluated: UA, low and high density lipoproteins (LDL-C, HDL-C), triglycerides (TG), fasting glucose (FG), creatinine; body mass index (BMI), waist circumference (WC), fat mass (FM), fat free mass (FFM) and total body water (TBW). Results. Positive correlations were shown between UA and LDL-C (p=0.041), TG (p<0.001), FG (p=0.025) and creatinine (p<0.001) and negative between UA and HDL-C (p<0.001). Significant associations between UA and anthropometric parameters and body components, such as WC (p<0.001), BMI (p<0.001), FFM (p<0.001) and TBW (p<0.001), were also observed. In the multiple regression model, independent predictors of UA concentration were serum creatinine and TBW (R2=0.45; p<0.001). Conclusions. In patients with AH, uric acid was significantly related to cardiovascular risk factors, including obesity. However, the main anthropometric determinant of plasma UA concentration is FFM. The consideration of body composition in the interpretation of UA concentration appears to be justified, but the verification of this hypothesis requires further studies.
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Diabetes is associated with endothelial dysfunction and platelet activation, both of which contribute to increased cardiovascular risk. We investigated whether the selective mineralocorticoid receptor (MR) antagonist eplerenone improves endothelial dysfunction and reduces platelet activation in diabetic rats. Male Wistar-rats were injected with streptozotocin (50 mg/kg i.v.) to induce insulin-deficient diabetes. After 2 weeks, treatment with eplerenone (100 mg/kg/day) or vehicle was initiated for 2 weeks. Aortic superoxide production determined by lucigenin-enhanced chemiluminescence and 2-hydroxyethidium formation was significantly increased in rats with diabetes and reduced by treatment with eplerenone (chemiluminescence: control 2045±227, STZ-placebo 3977±340, p<0.05 vs. control, STZ-eplerenone 1762±307, p<0.05 vs. STZ-placebo). Endothelium-dependent vasorelaxation was significantly attenuated in diabetic rats and was normalized by eplerenone (maximum relaxation in % of precontraction: control 95±3, STZ-placebo 82±3, p<0.01 vs. control, STZ-eplerenone 99±1, p<0.01 vs. STZ-placebo). Treatment with the selective MR antagonist significantly reduced fibrinogen-binding on activated GPIIb/IIIa (immunofluorescence: control 161±7, STZ-placebo 208±16, p<0.05 vs. control, STZ-eplerenone 173±6, p<0.05 vs. STZ-placebo). Eplerenone improves endothelial function by reducing superoxide formation and increasing NO bioavailability in diabetic rats. Platelet activation was significantly reduced by eplerenone. Selective MR blockade may constitute a useful therapeutic approach for treatment of vascular dysfunction in diabetes.
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