Primordial Prevention of Coronary Heart Disease in India: Challenges and Opportunities

The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) began as a province-wide inception cohort of all adult Alberta residents undergoing cardiac catheterization for ischemic heart disease. As of September 2017, clinical information has been collected by APPROACH on over 240,000 adult Alberta residents. Use of the APPROACH platform has also expanded across Canada and now facilitates the measurement and reporting of cardiovascular care across more than 18 major cardiovascular centres in 8 provinces. Strengths of the APPROACH initiative include the prospective collection of detailed clinical, procedural, and treatment information, measured at point-of-care. While this aspect of APPROACH provides data users with several advantages over of use of typical administrative data, the ability to link APPROACH with data from multiple other sources has provided several unique opportunities to measure cardiovascular care and outcomes. This paper describes applied examples of work that has leveraged the potential of linking several external datasets with the APPROACH registry.

Download Full-text

Implication of risk factors for coronary heart disease

Bangladesh Medical Journal Khulna ◽

10.3329/bmjk.v48i1-2.27095 ◽

2016 ◽

Vol 48 (1-2) ◽

pp. 28-31

Author(s):

Md Shahidul Basher ◽

ABM Maqsudul Haque ◽

Shikha Kabir ◽

Mohammad Mohammad Kamruzzaman Khan ◽

Mohammad Rashedul Hassan ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Odds Ratio ◽

Statistical Significance ◽

College Hospital ◽

Primordial Prevention ◽

Medical College ◽

Betel Leaf ◽

High Statistical Significance

A Case Control study was carried out to identify the risk factors of Coronary Heart Disease (CHD) at Mymensingh Medical College Hospital. As many as 96 patients were selected purposively as cases who were admitted with CHD at Coronary Care Unit, whereas an equal number of age, sex and religion matched controls were selected from patients admitted into Medicine Units during the study period. Data were collected by using pretested interview schedule after obtaining informed verbal consent. The mean age of the cases and controls, were 58.88 years with a Standard Deviation of 10.52 years. A highest number of cases and controls (87-90.62%) were males, while the rest 9 (9.38%) were females. Among cases 27 (28.13%) were illiterate, while of controls, 36 (37.50%) were illiterate. The association of smoking with the development of Coronary Heart Disease was statistically significant (P<O.05) with an odds ratio of 2.07. Family history of CHD had a very high statistical significance (p<0.001) with odds ratio 3.53. High statistical significance (p<0.01) was also observed between Diabetes Mellitus and Coronary Heart Disease with an odds ratio of 3.34. Coronary Heart Disease can be prevented through primordial prevention by hindering the development of baneful behaviours like habit of smoking, chewing betel leaf, use of tobacco and jarda, having fatty diet like meat.Bang Med J (Khulna) 2015; 48 : 28-31

Download Full-text

Cardiovascular Disease Events and Mortality After Myocardial Infarction Among Black and White Adults

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.120.006683 ◽

2020 ◽

Vol 13 (12) ◽

Author(s):

J. Walker Blackston ◽

Monika M. Safford ◽

Matthew T. Mefford ◽

Elizabeth Freeze ◽

George Howard ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Coronary Heart Disease ◽

Heart Disease ◽

Health Status ◽

Racial Differences ◽

Treatment Strategies ◽

Primordial Prevention ◽

Black And White ◽

White Adults

Background: Despite improvements in prognosis following myocardial infarction (MI), racial disparities persist. The objective of this study was to examine disparities between Black and White adults in cardiovascular disease (CVD), coronary heart disease, stroke, heart failure (HF), and mortality after MI and characteristics that may explain the disparities. Methods: This prospective cohort study included 1122 REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants with incident MI between 2003 and 2016. We followed participants for subsequent CVD events (MI, stroke, HF hospitalization, or death from CVD; n=431), coronary heart disease events (MI or death from coronary heart disease; (n=277), stroke (n=68), HF events (HF hospitalization or death from HF; n=191), and all-cause mortality (n=527; 3-year median follow-up after MI). Results: Among 1122 participants with incident MI, 37.5% were Black participants, 45.4% were women, and mean age was 73.2 (SD, 9.5) years. The unadjusted hazard ratio for CVD events comparing Black to White participants was 1.42 (95% CI, 1.17–1.71). Adjusting for sociodemographic characteristics did not attenuate the association (1.41 [95% CI, 1.14–1.73]), but further adjusting for pre-MI health status (1.25 [95% CI, 1.00–1.56]) and characteristics of the MI (1.01 [95% CI, 0.80–1.27]) resulted in substantial attenuation. Similar patterns were observed for the other outcomes, although the number of strokes was small. Conclusions: Black individuals had a higher risk of CVD events and mortality after MI than White individuals. The disparities were explained by health status before MI and characteristics of the MI. These findings suggest that both primordial prevention of risk factors and improved acute treatment strategies are needed to reduce disparities in post-MI outcomes.

Download Full-text