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Heart disease is the most common cause of ill health and preventable death. Cardiac rehabilitation is a programme that helps people with heart disease gain better health. It is held in group classes that take place at hospitals or within the community. People attend these classes once or twice a week for around six to eight weeks. The classes usually involve exercising, and receiving advice on ways to improve their health. People needing these programmes are not always able to attend them. An alternative is to provide this programme through the Internet. In this review we looked at whether programmes delivered through the Internet are helpful in improving death rates, the need for surgery, repeated heart attacks, cholesterol levels, blood pressure, health‐related quality of life (HRQOL), diet, physical activity, medication compliance, healthcare usage, and costs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 22, 2015

Ischaemic heart disease is the term used for conditions caused by a narrowing of the arteries that supply blood to the heart muscle. Patients may have angina, or may have had a previous myocardial infarction (heart attack) or surgery to widen or bypass the affected arteries. "Secondary prevention" is the term used to describe health care that aims to prevent further events or the worsening of such conditions in these patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 17, 2010

We wanted to find out the effects on health of cutting down on saturated fat in our food (replacing animal fats with plant oils, unsaturated spreads and more starchy foods).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 10, 2015

In many countries, there is enthusiasm for 'healthy heart programmes' that use counselling and educational methods to encourage people to reduce their risks for developing heart disease. These risk factors include high cholesterol, excessive salt intake, high blood pressure, excess weight, a high‐fat diet, smoking, diabetes and a sedentary lifestyle. This review is an update of all relevant randomised trials that have evaluated an intervention that aimed to reduce more than one risk factor (multiple risk factor intervention) in people without evidence of cardiovascular disease. The findings are from 55 trials of between six months and 12 years duration conducted in several countries over the course of four decades. The median duration of follow up was 12 months (with a range of six months to 12 years). Multiple risk factor intervention does result in small reductions in risk factors including blood pressure, cholesterol and smoking. Contrary to expectations, multiple risk factor interventions had little or no impact on the risk of coronary heart disease mortality or morbidity. This could be because these small risk factor changes were not maintained in the long term. Alternatively, the small reductions in risk factors may be caused by biases in some of the studies. The methods of attempting behaviour change in the general population are limited and do not appear to be effective. Different approaches to behaviour change are needed and should be tested empirically before being widely promoted, particularly in developing countries where cardiovascular disease rates are rising. Further trials may be warranted.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 19, 2011

Chronic diseases are a significant and growing challenge in Canada. In the province of Ontario, for example, 33% of people were living with at least one chronic disease in 2005. Diabetes, heart disease and HIV/AIDS are three of the most common health chronic conditions in Canada for which education, coaching, and other interventions such as peer support may help patients to gain the confidence, knowledge, skills, and motivation to manage their disease.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 8, 2013

Systematic reviews conducted as part of the Evidence-based Practice Center (EPC) program routinely identify evidence gaps and suggest further research to help close these gaps, but there is little evidence that these suggestions lead to the performance of the needed research. As part of an EPC-wide program to evaluate potential mechanisms for ensuring that research needs identified by systematic reviews are addressed, the Duke EPC reviewed the use of modeling techniques, including value-of-information (VOI) analysis, for prioritizing research gaps, under the assumption that quantitative prioritization could help facilitate the performance of research to address those gaps.

Methods Future Research Needs Reports - Agency for Healthcare Research and Quality (US).

Version: June 2011

The study found that it is feasible to address several of the important problems faced by guideline developers when attempting to account for multimorbidity.

Health Services and Delivery Research - NIHR Journals Library.

Version: April 2017

While the NHS in England and Wales has made spectacular progress in improving the secondary prevention of cardiovascular disease, we now need to work harder to identify those who are at particularly high risk of myocardial infarction.

NICE Clinical Guidelines - National Collaborating Centre for Primary Care (UK).

Version: August 2008

The development of cholesterol-rich plaque within the walls of coronary arteries (atherosclerosis) is the pathological process which underlies ‘coronary artery disease’. However, the clinical manifestations of this generic condition are varied. When the atherosclerotic process advances insidiously the lumen of a coronary artery becomes progressively narrowed blood supply to the myocardium is compromised (ischaemia) and the affected individual will often develop predictable exertional chest discomfort, or ‘stable’ angina. However, at any stage in the development of atherosclerosis, and often when the coronary artery lumen is narrowed only slightly or not at all, an unstable plaque may develop a tear of its inner lining cell layer (intima), exposing the underlying cholesterol rich atheroma within the vessel wall to the blood flowing in the lumen. This exposure stimulates platelet aggregation and subsequent clot (thrombus) formation.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: 2010

We conducted this systematic evidence review of trials of physical activity and/or dietary counseling to prevent cardiovascular disease (CVD) to assist the U.S. Preventive Services Task Force (USPSTF) in updating its 2002 and 2003 recommendations on counseling to improve physical activity and diet, respectively.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: December 2010

We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its 2012 recommendation on behavioral counseling to promote a healthful diet and physical activity for the primary prevention of cardiovascular disease (CVD) in adults without known CVD risk factors. Our review addressed four key questions: 1) Do primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior improve health outcomes in adults? 2) Do primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior improve intermediate outcomes associated with CVD in adults? 3) Do primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior improve associated health behaviors in adults? 4) What adverse events are associated with primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior in adults?

Evidence Synthesis - Agency for Healthcare Research and Quality (US).

Version: July 2017

Both the US Preventive Services Task Force (USPSTF) and the National Cholesterol Education Program (NCEP ATP III) have issued recommendations on screening for dyslipidemia in adults. To guide the USPSTF in updating its 2001 recommendations, we reviewed evidence relevant to discrepancies between these recommendations.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: June 2008

Coronary heart disease is the leading cause of death in the United States in adults. Traditional risk factors do not account for all of the excess risk associated with coronary heart disease. Screening for abnormalities with resting or exercise electrocardiography (ECG) could help identify persons at higher risk for coronary heart disease who might benefit from interventions to reduce cardiovascular risk.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: September 2011

Diet recommendations vary according to the stage of chronic kidney disease. If you pay attention to what you eat and drink, and get enough exercise too, you can have a positive impact on the course of the disease and improve your wellbeing. A lot of metabolic processes depend on the performance of the kidneys: If your kidneys stop working properly, it causes an imbalance in your energy and protein metabolism, for instance. The levels of salts and fluids in the body are also affected. Advanced kidney disease may then cause serious complications such as weight loss, acidosis (a build-up of acid), and fluid retention in organs and tissue. So people who have chronic kidney disease are advised to follow a number of dietary recommendations. It’s often quite difficult to stick to this special "kidney-friendly" diet. But doctors and dietitians can help you to understand the recommendations and put them into practice. People who have chronic kidney disease often get used to these recommendations over time and use them as an opportunity to do something good for their wellbeing. Changes to your diet and exercise also have a positive effect on other medical conditions and risk factors, such as high blood pressure.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 8, 2018

Problems with mineral and bone metabolism are very common in people with chronic kidney disease (CKD) which can lead to broken bones (fracture), heart and blood circulation (cardiovascular) problems, and sometimes death. Many pharmaceutical treatments used to treat mineral‐bone disease can have side effects and cause problems for patients. We wanted to find out if specific diets (such as low protein or phosphorus intake) were better or worse than normal diets or pharmaceutical treatments.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 16, 2015

Whole grain foods encompass a range of products and include whole grain wheat, rice, maize, and oats. The term 'whole grain' also includes milled whole grains such as oatmeal and wholemeal wheat.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: August 24, 2017

This guideline updates for primary prevention, the NICE technology appraisal, ‘Statins for the prevention of cardiovascular events’ (TA94, 2007) and reviews and updates the recommendations made in the NICE guideline Lipid Modification (CG67, 2008) for primary and secondary prevention of cardiovascular disease (CVD). The scope for this guideline was limited to the identification and assessment of CVD risk and to the assessment and modification of lipids in people at risk of CVD, or people with known CVD. The guideline development group wishes to make clear that lipid modification should take place as part of a programme of risk reduction which also include attention to the management of all other known CVD risk factors.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: July 2014

Diet and activity interventions in pregnancy reduce gestational weight gain, with no significant benefit for a composite of maternal and fetal outcomes, irrespective of maternal characteristics, and are not cost-effective

Health Technology Assessment - NIHR Journals Library.

Version: August 2017

This guideline covers areas relevant to the diagnosis and management of irritable bowel syndrome (IBS) reflecting the complete patient journey, from the person presenting with IBS symptoms, positive diagnosis and management, targeted at symptom control. The guideline incorporates Cochrane reviews, published NICE clinical and public health guidance, Health Technology Assessment reports, systematic and health economic reviews produced by the National Collaborating Centre for Nursing and Supportive Care. Recommendations are based on clinical and cost effectiveness evidence, and where this is insufficient, the GDG used all available information sources and experience to make consensus recommendations using nominal group technique.

NICE Clinical Guidelines - National Collaborating Centre for Nursing and Supportive Care (UK).

Version: February 2008

This guideline aims to provide advice on the assessment and management of children and young people with bedwetting. The guidance is applicable to children and young people up to 19 years with the symptom of bedwetting. It has been common practice to define enuresis as abnormal from 5 years and only to consider children for treatment when they are 7 years. While the prevalence of symptoms decreases with age the guideline scope did not specify a younger age limit in order to consider whether there were useful interventions that might be of benefit to children previously excluded from advice and services.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: 2010

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