Hospital Italiano de La Plata, AR.
Instituto Nacional de Cardiologia Ignacio Chavez, MX.
Glob Heart. 2021 Feb 17;16(1):15. doi: 10.5334/gh.932.
SARS-CoV-2 pandemic has modified the cardiovascular care of ambulatory patients. The aim of this survey was to study changes in lifestyle habits, treatment adherence, and mental health status in patients with cardiometabolic disease, but no clinical evidence of COVID-19.
A cross-sectional survey was conducted in ambulatory patients with cardiometabolic disease using paper/digital surveys. Variables investigated included socioeconomic status, physical activity, diet, tobacco use, alcohol intake, treatment discontinuation, and psychological symptoms.
A total of 4,216 patients (50.9% males, mean age 60.3 ± 15.3 years old) from 13 Spanish-speaking Latin American countries were enrolled. Among the study population, 46.4% of patients did not have contact with a healthcare provider, 31.5% reported access barriers to treatments and 17% discontinued some medication. Multivariate analysis showed that non-adherence to treatment was more prevalent in the secondary prevention group: peripheral vascular disease (OR 1.55, CI 1.08-2.24; p = 0.018), heart failure (OR 1.36, CI 1.05-1.75; p = 0.017), and coronary artery disease (OR 1.29 CI 1.04-1.60; p = 0.018). No physical activity was reported by 38% of patients. Only 15% of patients met minimum recommendations of physical activity (more than 150 minutes/week) and vegetable and fruit intake. Low/very low income (45.5%) was associated with a lower level of physical activity (p < 0.0001), less fruit and vegetables intake (p < 0.0001), more tobacco use (p < 0.001) and perception of depression (p < 0.001). Low educational level was also associated with the perception of depression (OR 1.46, CI 1.26-1.70; p < 0.01).
Patients with cardiometabolic disease but without clinical evidence of COVID-19 showed significant medication non-adherence, especially in secondary prevention patients. Deterioration in lifestyle habits and appearance of depressive symptoms during the pandemic were frequent and related to socioeconomic status.
SARS-CoV-2 大流行改变了门诊患者的心血管护理。本研究旨在研究无 COVID-19 临床证据的心血管代谢疾病患者生活方式习惯、治疗依从性和心理健康状况的变化。
采用纸质/数字问卷调查对心血管代谢疾病门诊患者进行横断面调查。调查的变量包括社会经济状况、身体活动、饮食、吸烟、饮酒、治疗中断和心理症状。
共纳入来自 13 个西班牙语拉丁美洲国家的 4216 名患者（50.9%为男性，平均年龄 60.3±15.3 岁）。研究人群中，46.4%的患者未与医疗保健提供者接触，31.5%报告治疗存在障碍，17%停止了某些药物治疗。多变量分析显示，二级预防组患者的治疗不依从更为常见：外周血管疾病（OR 1.55，95%CI 1.08-2.24；p=0.018）、心力衰竭（OR 1.36，95%CI 1.05-1.75；p=0.017）和冠状动脉疾病（OR 1.29，95%CI 1.04-1.60；p=0.018）。38%的患者没有进行任何身体活动。仅有 15%的患者达到了每周进行超过 150 分钟身体活动及摄入蔬菜和水果的最低推荐量。低收入/极低收入（45.5%）与较低水平的身体活动（p<0.0001）、较少摄入蔬菜和水果（p<0.0001）、更多吸烟（p<0.001）和抑郁感（p<0.001）相关。低教育水平也与抑郁感相关（OR 1.46，95%CI 1.26-1.70；p<0.01）。
无 COVID-19 临床证据的心血管代谢疾病患者存在明显的药物治疗不依从，尤其是在二级预防患者中。大流行期间生活方式习惯恶化和抑郁症状的出现较为常见，且与社会经济地位相关。
