Physical inactivity is a major global public health issue associated with a range of chronic disease outcomes. As such, the underlying motivation and barriers to whether or not an individual engages ...in physical activity is of critical public health importance. This study examines the National Heart Foundation of Australia Heart Week Survey conducted in March 2015. A total of 894 (40% female) Australian adults aged 25⁻54 years completed the survey, including items relating to motivation and barriers to being physically active. The most frequently selected responses regarding motivation for physical activity among those categorised as active (
= 696) were; to lose or maintain weight (36.6%, 95% CI 33.1⁻40.3), avoid or manage health condition (17.8%, 95% CI 15.1⁻20.8), and improve appearance (12.8%, 95% CI 10.5⁻15.5). Some gender differences were found with a greater proportion of females (43.8%, 95% CI 38.0⁻49.8) reporting lose or maintain weight as their main motivation for being physically active compared to males (31.9%, 95% CI 27.7⁻36.6). Among those categorised as inactive (
= 198), lack of time (50.0%, 95% CI 43.0⁻56.8) was the most frequently reported barrier to physical activity. While empirical studies seek to understand the correlates and determinants of physical activity, it is critical that beliefs and perceptions enabling and prohibiting engagement are identified in order to optimise physical activity promotion in the community.
To explore the association of different types of blood pressure (BP) variability measures estimated from either short-term ambulatory reading-to-reading or long-term clinic visit-to-visit BP records ...with long-term survival in an elderly treated hypertensive population.
A subset of patients (n = 508) aged at least 65-years was studied from the Second Australian National Blood Pressure study. We estimated SBP and DBP BP variability as the SD of ambulatory (24-h, daytime, night-time) and clinic visit-to-visit BP directly from all corresponding on-treatment within-individual BP records. Ambulatory 'weighted day-night' variability was calculated as a weighted mean of daytime and night-time SD. Cox-proportional hazard models adjusted for baseline risk factors (Model 1) and corresponding on-treatment BP (Model 2) or average night-time SBP (best predictive BP measure for outcome) (Model 3) were used to determine the relationship between long-term outcome and BP variability.
Over a median of 10.6 years, 101 patients died from any cause, of which 51 deaths were cardiovascular. We observed increase in 'daytime' and 'weighted day-night' SBP/DBP variability was significantly associated with increased all-cause mortality in all models. For cardiovascular mortality, only 'weighted day-night' SBP variability significantly predicted risk in all models (Model 3 hazard ratio: 1.09, 95% confidence interval: 1.00-1.19, P = 0.04). Long-term BP variability was not associated with any outcome. On direct comparison, both 'daytime' and 'weighted day-night' BP variability measures provided similar prognostic information.
Short-term 'daytime' and 'weighted day-night' SBP variability from ambulatory BP recordings was a better predictor of mortality in elderly treated hypertensive patients than long-term BP variability from visit-to-visit BP recordings.
Releasing timely and relevant clinical guidelines is challenging for organizations globally. Priority-setting is crucial, as guideline development is resource-intensive. Our aim, as a national ...organization responsible for developing cardiovascular clinical guidelines, was to develop a method for generating and prioritizing topics for future clinical guideline development in areas where guidance was most needed.
Several novel processes were developed, adopted and evaluated, including (1) initial public consultation for health professionals and the general public to generate topics; (2) thematic and qualitative analysis, according to the International Classification of Diseases (ICD-11), to aggregate topics; (3) adapting a criteria-based matrix tool to prioritize topics; (4) achieving consensus through a modified-nominal group technique and voting on priorities; and (5) process evaluation via survey of end-users. The latter comprised the organization's Expert Committee of 12 members with expertise across cardiology and public health, including two citizen representatives.
Topics (n = 405; reduced to n = 278 when duplicates removed) were identified from public consultation responses (n = 107 respondents). Thematic analysis synthesized 127 topics that were then categorized into 37 themes using ICD-11 codes. Exclusion criteria were applied (n = 32 themes omitted), resulting in five short-listed topics: (1) congenital heart disease, (2) valvular heart disease, (3) hypercholesterolaemia, (4) hypertension and (5) ischaemic heart diseases and diseases of the coronary artery. The Expert Committee applied the prioritization matrix to all five short-listed topics during a consensus meeting and voted to prioritize topics. Unanimous consensus was reached for the topic voted the highest priority: ischaemic heart disease and diseases of the coronary arteries, resulting in the decision to update the organization's 2016 clinical guidelines for acute coronary syndromes. Evaluation indicated that initial public consultation was highly valued by the Expert Committee, and the matrix tool was easy to use and improved transparency in priority-setting.
Developing a multistage, systematic process, incorporating public consultation and an international classification system led to improved transparency in our clinical guideline priority-setting processes and that topics chosen would have the greatest impact on health outcomes. These methods are potentially applicable to other national and international organizations responsible for developing clinical guidelines.
To assess the association of pet ownership and all-cause and cardiovascular mortality over a long-term follow-up among elderly treated hypertensive participants.
Pet-ownership data from a subcohort ...of the Second Australian National Blood Pressure study were used. Participants were aged 65-84 years at enrolment (1995-1997) and responded to a pet-ownership questionnaire during year 2000. Participants' survival information was determined over a median of 10.9 years that includes Second Australian National Blood Pressure in-trial period (median 4.2 years) together with posttrial follow-up period (median 6.9 years). For the current study, end points were any fatal cardiovascular event and all-cause fatal events.
Of those who responded to a pet-ownership questionnaire (4039/6018 - 67%), 86% (3490/4039) owned at least one pet at any-time during their life (current or previous pet owner), with 36% (1456/4039) owning at least one pet at the time of the survey. During the follow-up period, 958 participants died including 499 deaths of cardiovascular origin. Using a Cox proportional hazard regression model adjusting for possible confounders, there was a 22 and 26% reduction in cardiovascular mortality observed among previous and current pet owners, respectively, compared with those who had never owned one. A similar nonsignificant trend was observed for all-cause mortality once adjusted for potential confounders.
Pet ownership was associated with an improved cardiovascular disease survival in a treated elderly hypertensive population.
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