Self-care and pathophysiological function in patients with chronic heart failure

Dionne Kessing, Johan Denollet, Jos Widdershoven, Nina Kupper*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

Background
Self-care is assumed to benefit physiological function associated with prognosis in patients with chronic HF, but studies examining these relations are lacking. This study aims to prospectively examine the association of self-reported HF self-care with HF-associated pathophysiological markers, including renal, hematological, and immune function.
Method
Patients with chronic HF (n = 460, 66.2 ± 9.6 years, 75% men) completed questionnaires and provided blood samples at baseline and 12-month follow-up. Linear mixed models examined random intercept and fixed between- and within-subjects effects of global self-care and the individual self-care behaviors on log-transformed TNF-α, IL-6, and IL-10, the glomerular filtration rate of creatinine (GFRcreat), and hemoglobin (Hb), controlling for sociodemographic and clinical covariates.
Results
Self-care was independently associated with lower GFRcreat levels (β = − .14, P = .023) and improvement in self-care with a reduction in GFRcreat (β = − .03, P = .042). Individual self-care behaviors were differentially associated with renal, inflammatory, and hematological markers. Regular exercise was associated with level differences in IL-6 (P < .001), and improvement in exercise was associated with increasing GFRcreat (P = .002) and increasing Hb (P = .010). Fluid restriction was associated with lower overall GFRcreat (P = .006), and improvement in fluid restriction was associated with decreasing GFRcreat (P = .014). Low-sodium intake was associated with lower levels of Hb (P = .027), lower TNF-alpha (P = .011), and lower IL-10 (P = .029). Higher levels of medication adherence were associated with reduced pro-inflammatory activation (P < .007).
Conclusion
Our findings suggest that better global self-care was associated with poorer renal function. Performing self-care behaviors such as regular exercise and medication adherence was associated with improved physiological functioning, while restriction of fluid and sodium, and the associated daily weight monitoring were associated with adverse levels of pathophysiological biomarkers.
Original languageEnglish
Pages (from-to)629–644
JournalInternational Journal of Behavioral Medicine
Volume26
Issue number6
DOIs
Publication statusPublished - 2019

Fingerprint

Glomerular Filtration Rate
Creatinine
Medication Adherence
Exercise
Kidney
Interleukin-10
Interleukin-6
Linear Models
Tumor Necrosis Factor-alpha
Weights and Measures

Keywords

  • ANEMIA
  • Adherence
  • Anemia
  • BEHAVIOR SCALE
  • BIOMARKERS
  • EXERCISE
  • HOSPITALIZATION
  • Heart failure
  • INFLAMMATION
  • Inflammation
  • METAANALYSIS
  • MORTALITY
  • PREDICTORS
  • PREVALENCE
  • Renal function
  • Self-care

Cite this

@article{5735748b34ed4b91a024f5d1b0f48847,
title = "Self-care and pathophysiological function in patients with chronic heart failure",
abstract = "BackgroundSelf-care is assumed to benefit physiological function associated with prognosis in patients with chronic HF, but studies examining these relations are lacking. This study aims to prospectively examine the association of self-reported HF self-care with HF-associated pathophysiological markers, including renal, hematological, and immune function.MethodPatients with chronic HF (n = 460, 66.2 ± 9.6 years, 75{\%} men) completed questionnaires and provided blood samples at baseline and 12-month follow-up. Linear mixed models examined random intercept and fixed between- and within-subjects effects of global self-care and the individual self-care behaviors on log-transformed TNF-α, IL-6, and IL-10, the glomerular filtration rate of creatinine (GFRcreat), and hemoglobin (Hb), controlling for sociodemographic and clinical covariates.ResultsSelf-care was independently associated with lower GFRcreat levels (β = − .14, P = .023) and improvement in self-care with a reduction in GFRcreat (β = − .03, P = .042). Individual self-care behaviors were differentially associated with renal, inflammatory, and hematological markers. Regular exercise was associated with level differences in IL-6 (P < .001), and improvement in exercise was associated with increasing GFRcreat (P = .002) and increasing Hb (P = .010). Fluid restriction was associated with lower overall GFRcreat (P = .006), and improvement in fluid restriction was associated with decreasing GFRcreat (P = .014). Low-sodium intake was associated with lower levels of Hb (P = .027), lower TNF-alpha (P = .011), and lower IL-10 (P = .029). Higher levels of medication adherence were associated with reduced pro-inflammatory activation (P < .007).ConclusionOur findings suggest that better global self-care was associated with poorer renal function. Performing self-care behaviors such as regular exercise and medication adherence was associated with improved physiological functioning, while restriction of fluid and sodium, and the associated daily weight monitoring were associated with adverse levels of pathophysiological biomarkers.",
keywords = "ANEMIA, Adherence, Anemia, BEHAVIOR SCALE, BIOMARKERS, EXERCISE, HOSPITALIZATION, Heart failure, INFLAMMATION, Inflammation, METAANALYSIS, MORTALITY, PREDICTORS, PREVALENCE, Renal function, Self-care",
author = "Dionne Kessing and Johan Denollet and Jos Widdershoven and Nina Kupper",
year = "2019",
doi = "10.1007/s12529-019-09822-2",
language = "English",
volume = "26",
pages = "629–644",
journal = "International Journal of Behavioral Medicine",
issn = "1070-5503",
publisher = "Springer",
number = "6",

}

Self-care and pathophysiological function in patients with chronic heart failure. / Kessing, Dionne; Denollet, Johan; Widdershoven, Jos; Kupper, Nina.

In: International Journal of Behavioral Medicine, Vol. 26, No. 6, 2019, p. 629–644.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Self-care and pathophysiological function in patients with chronic heart failure

AU - Kessing, Dionne

AU - Denollet, Johan

AU - Widdershoven, Jos

AU - Kupper, Nina

PY - 2019

Y1 - 2019

N2 - BackgroundSelf-care is assumed to benefit physiological function associated with prognosis in patients with chronic HF, but studies examining these relations are lacking. This study aims to prospectively examine the association of self-reported HF self-care with HF-associated pathophysiological markers, including renal, hematological, and immune function.MethodPatients with chronic HF (n = 460, 66.2 ± 9.6 years, 75% men) completed questionnaires and provided blood samples at baseline and 12-month follow-up. Linear mixed models examined random intercept and fixed between- and within-subjects effects of global self-care and the individual self-care behaviors on log-transformed TNF-α, IL-6, and IL-10, the glomerular filtration rate of creatinine (GFRcreat), and hemoglobin (Hb), controlling for sociodemographic and clinical covariates.ResultsSelf-care was independently associated with lower GFRcreat levels (β = − .14, P = .023) and improvement in self-care with a reduction in GFRcreat (β = − .03, P = .042). Individual self-care behaviors were differentially associated with renal, inflammatory, and hematological markers. Regular exercise was associated with level differences in IL-6 (P < .001), and improvement in exercise was associated with increasing GFRcreat (P = .002) and increasing Hb (P = .010). Fluid restriction was associated with lower overall GFRcreat (P = .006), and improvement in fluid restriction was associated with decreasing GFRcreat (P = .014). Low-sodium intake was associated with lower levels of Hb (P = .027), lower TNF-alpha (P = .011), and lower IL-10 (P = .029). Higher levels of medication adherence were associated with reduced pro-inflammatory activation (P < .007).ConclusionOur findings suggest that better global self-care was associated with poorer renal function. Performing self-care behaviors such as regular exercise and medication adherence was associated with improved physiological functioning, while restriction of fluid and sodium, and the associated daily weight monitoring were associated with adverse levels of pathophysiological biomarkers.

AB - BackgroundSelf-care is assumed to benefit physiological function associated with prognosis in patients with chronic HF, but studies examining these relations are lacking. This study aims to prospectively examine the association of self-reported HF self-care with HF-associated pathophysiological markers, including renal, hematological, and immune function.MethodPatients with chronic HF (n = 460, 66.2 ± 9.6 years, 75% men) completed questionnaires and provided blood samples at baseline and 12-month follow-up. Linear mixed models examined random intercept and fixed between- and within-subjects effects of global self-care and the individual self-care behaviors on log-transformed TNF-α, IL-6, and IL-10, the glomerular filtration rate of creatinine (GFRcreat), and hemoglobin (Hb), controlling for sociodemographic and clinical covariates.ResultsSelf-care was independently associated with lower GFRcreat levels (β = − .14, P = .023) and improvement in self-care with a reduction in GFRcreat (β = − .03, P = .042). Individual self-care behaviors were differentially associated with renal, inflammatory, and hematological markers. Regular exercise was associated with level differences in IL-6 (P < .001), and improvement in exercise was associated with increasing GFRcreat (P = .002) and increasing Hb (P = .010). Fluid restriction was associated with lower overall GFRcreat (P = .006), and improvement in fluid restriction was associated with decreasing GFRcreat (P = .014). Low-sodium intake was associated with lower levels of Hb (P = .027), lower TNF-alpha (P = .011), and lower IL-10 (P = .029). Higher levels of medication adherence were associated with reduced pro-inflammatory activation (P < .007).ConclusionOur findings suggest that better global self-care was associated with poorer renal function. Performing self-care behaviors such as regular exercise and medication adherence was associated with improved physiological functioning, while restriction of fluid and sodium, and the associated daily weight monitoring were associated with adverse levels of pathophysiological biomarkers.

KW - ANEMIA

KW - Adherence

KW - Anemia

KW - BEHAVIOR SCALE

KW - BIOMARKERS

KW - EXERCISE

KW - HOSPITALIZATION

KW - Heart failure

KW - INFLAMMATION

KW - Inflammation

KW - METAANALYSIS

KW - MORTALITY

KW - PREDICTORS

KW - PREVALENCE

KW - Renal function

KW - Self-care

U2 - 10.1007/s12529-019-09822-2

DO - 10.1007/s12529-019-09822-2

M3 - Article

VL - 26

SP - 629

EP - 644

JO - International Journal of Behavioral Medicine

JF - International Journal of Behavioral Medicine

SN - 1070-5503

IS - 6

ER -