Arch Intern Med
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Multicenter Study Comparative Study
Depression and medication adherence in outpatients with coronary heart disease: findings from the Heart and Soul Study.
Depression leads to adverse outcomes in patients with coronary heart disease (CHD). Medication nonadherence is a potential mechanism for the increased risk of CHD events associated with depression, but it is not known whether depression is associated with medication nonadherence in outpatients with stable CHD. ⋯ Depression is associated with medication nonadherence in outpatients with CHD. Medication nonadherence may contribute to adverse cardiovascular outcomes in depressed patients.
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Physical inactivity is a modifiable risk factor for cardiovascular disease. However, little is known about the effects of physical activity on life expectancy with and without cardiovascular disease. Our objective was to calculate the consequences of different physical activity levels after age 50 years on total life expectancy and life expectancy with and without cardiovascular disease. ⋯ Avoiding a sedentary lifestyle during adulthood not only prevents cardiovascular disease independently of other risk factors but also substantially expands the total life expectancy and the cardiovascular disease-free life expectancy for men and women. This effect is already seen at moderate levels of physical activity, and the gains in cardiovascular disease-free life expectancy are twice as large at higher activity levels.
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We analyzed data from a single menstrual cycle from 630 women, aged 43 to 53 years, in the Daily Hormone Study component of the Study of Women's Health Across the Nation to determine whether hormone levels are associated with trouble sleeping as women enter the menopausal transition. ⋯ In this community-based sample of middle-aged women, the most trouble sleeping was observed at the beginning and end of the menstrual cycle.
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Multicenter Study Comparative Study
Variation in the tendency of primary care physicians to intervene.
Research has documented dramatic variation in health care spending across the United States that has little relationship to health outcomes. Although high-spending areas have more physicians per capita, it is not known whether this disparity fully explains the differences in spending or whether individual physicians in high-spending regions have a greater tendency to intervene for their patients. We sought to measure the tendency of primary care physicians to intervene across regions that differ in their levels of local health care spending. ⋯ Varying rates of health care spending across the United States reflect the underlying tendency of local physicians to recommend interventions for their patients.
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Multicenter Study Comparative Study
Justice at work and reduced risk of coronary heart disease among employees: the Whitehall II Study.
Justice is a fundamental value in human societies, but its effect on health is poorly described. We examined justice at work as a predictor of coronary heart disease (CHD). ⋯ Justice at work may have benefits for heart health among employees.