Disparities in Secondary Prevention between Stroke and Coronary Heart Disease in China: Cross-Sectional Community-Based Study, 2014–2016

2021 ◽  
pp. 1-10
Author(s):  
Shijun Xia ◽  
Chi Wang ◽  
Xin Du ◽  
Lizhu Guo ◽  
Jing Du ◽  
...  

<b><i>Background:</i></b> Health care quality and insurance coverage have improved with economic development in China, but the burden of cardiovascular diseases (CVDs) continues to increase with ongoing gaps in prevention. We aimed to compare the uptake of secondary CVD prevention between stroke and coronary heart disease (CHD) patients in China. <b><i>Methods:</i></b> In a cross-sectional community-based survey of 47,841 adults (age ≥45 years) in 7 regions of China between 2014 and 2016, we identified those with a history of stroke or CHD to quantify disparities in conventional secondary CVD prevention strategies in multivariable logistic regression models. <b><i>Results:</i></b> There were 4,105 and 1,022 participants with a history of stroke and CHD, respectively. Compared to participants with CHD, those with a history of stroke were significantly less likely to be taking blood-pressure-lowering (39.7% vs. 53%), lipid-lowering (13.7% vs. 36.8%), and antiplatelet (20.8% vs. 50.6%) agents, at least one (48.9% vs. 70.8%) or all 3 recommended medicines (6.1% vs. 24.0%), and were less likely to achieve a lipid-cholesterol target (30.3% vs. 44.0%). Participants with a history of stroke achieved less optimal secondary prevention goals for medication use, either from any (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.44–0.66) or all 3 medications (aOR 0.27, 95% CI 0.20–0.36), as well as better blood pressure (aOR 0.81, 95% CI 0.66–0.98) and low-density lipoprotein cholesterol (aOR 0.34, 95% CI 0.27–0.43) levels of control. There were no significant differences in weight, smoking, or physical activity between the groups. <b><i>Conclusion:</i></b> Stroke patients had lower use of secondary CVD-preventive medication and achieved lower levels of risk factor control than those of CHD patients in China. Nationwide disease-specific strategies, and better education of participants and health care providers, may narrow these gaps.

2006 ◽  
Vol 6 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Olivera Batić-Mujanović ◽  
Muharem Zildžić ◽  
Azijada Beganlić

Significant increase in mortality from coronary heart disease (CHD) has been seen in Bosnia and Herzegovina in the past decade. Little is known about current secondary preventive practices and treatments among patients with CHD in primary health care. The aims of this study were to evaluate the components of secondary prevention for CHD and to detect possible gender differences. This trial included 70 patients, aged 40-70 years, with established CHD from Family Medicine Teaching Center Tuzla. We evaluated components of secondary prevention(serum total cholesterol and blood pressure levels, smoking habits, body mass index, using aspirin, ACE inhibitors and lipid lowering drugs) in all participants. Results showed that significantly more men than women had diagnosis of CHD. 26/70 (37.14%) patients had myocardial infarction, with significantly higher number of men than women, but more women had angina only. Mean systolic blood pressure was 148.09+/-20.22 and diastolic 91.62+/-10.17 mmHg; mean total cholesterol level was 6.23+/-1.33 mmol/l; mean BMI was 27.9+/-3.32 kg/m(2). Blood pressure was managed according to guidelines in 19 (27.14%), and lipid concentrations in 11 (15.71%) patients. 55/70 (78.71%) patients took aspirin, only 18/70 (25.71%) patients took lipid lowering therapy, and 20/23 (86.96%) patients with heart failure took ACE inhibitors. 16/70 (22.86%) patients were current smokers, only 19/70 (27.14%) patients had healthy body mass index, while 21/70 (30%) patients were obese. Results of this study show a suboptimal secondary prevention in primary health care, which indicate more effective public health messages and changes in the healthcare system that promotes preventive strategies.


2020 ◽  
Vol 11 (1) ◽  
pp. 22-28
Author(s):  
Md Saydur Rahman ◽  
Nurun Nahar

Background: Cardiovascular risk factors are the most inimical and deleterious elements to develop coronary heart disease (CHD). To identify the factors contributing to develop CHD is therefore of paramount importance. It needs endless attention to address the riddle. This effort is to candle the light on sociodemographic & other factors of CHD. Methods & Materials: This cross-sectional study was conducted in CMH Dhaka from September to December 2011 on 287 respondents. Data were collected by interview using semi-structured questionnaire. Data were checked, edited, coded, categorized, cleaned and analyzed using (SPSS version 20). Results: The study disclosed that respondent's mean age was 39.40+9.42 years, 67.2% were male and 32.8% were female. It was founded that 34.14% were smoker. The prevalence rate of HTN and DM were 14.3% and 4.5% respectably. The mean BMI was 24.55 with 58.5% had normal weight and 41.5% were overweight, 18.8% had positive family history of suffering from CHD. among the respondents 88.5% has got at least one risk factor, 60% has got 5-10 risk factors, 13.6% got 6-10 risk factors, 14.3% got>10 risk factors. Age was significantly associated with smoking (p<.049), educational status (p<.001) and blood pressure (p<.001). Physical exercise was associated with BMI (p<.001) and blood pressure (p<.001). Risk factors had highly significant association with age (p<.001). Conclusion: All these findings suggest that a substantial evidence of risk factors of coronary heart diseases were prevailing among the study population. Proper care through positive motivation, avoidance of risk behaviour, intervention of clinical conditions can resist risk factors of coronary heart disease thus coronary heart disease can be prevented. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 22-28


2016 ◽  
Vol 43 (2) ◽  
pp. 51
Author(s):  
Murti Andriastuti ◽  
Sudigdo Sastroasmoro ◽  
Agus Firmansyah

Background Morbidity and mortality of coronary heart disease(CHD) are recently increasing. This is related to changes in lifestyle,such as lack of activity and high consumption of fatty diet. Themain cause of CHD is atherosclerosis. The development of ath-erosclerosis takes a long time, is asymptomatic, and might beginin childhood. The important risk factors that have roles in increas-ing the likelihood of atherosclerosis are family history of prematureCHD, hypertension, hyperlipidemia, obesity, smoking and irregu-lar activity.Objective The aim of this study was to find out the prevalence ofCHD risk factors in children and young adults who had parentalhistory of premature CHD.Methods This was a descriptive cross sectional study conductedon offspring of premature CHD patients who were admitted in theintensive cardiology care unit (ICCU) of Cipto MangunkusumoHospital between January 1999 to December 2001 and of prema-ture CHD patients who visited the Cardiology Clinic of the Depart-ment of Internal Medicine, Cipto Mangunkusumo Hospital duringMarch and April 2002. Subjects were aged 12 to 25 year-old.Results Among the subjects, 40% had hyperlipidemia, 8% hadhypertension, 11% were obese, 21% were active smokers, 41%were passive smokers, and 73% had irregular activity. Ninety-sevenpercents subjects had more than 1 risk factors.Conclusions The prevalence of hyperlipidemia, hypertension,obesity, passive smoker, active smoker and irregular activity inchildren and young adults with parental history of premature CHDin this study were higher than those in the normal population.Most had more than 1 risk factor, increasing the likelihood of CHD.A screening test should be performed on children with parentalhistory of premature CHD so that early preventive measures mightbe done to minimize the risk factors


2021 ◽  
Vol 11 (3) ◽  
pp. 9-13
Author(s):  
Nourollah Ramroodi ◽  
Seyed Mehdi Hashemi ◽  
Mehrdad Ramroudi

Objective: The aim of the present study was to investigate the epidemiological pattern of factors associated with ischemic stroke among patients under 50 years old. Methods: The present cross-sectional study was performed on 197 Stroke patients. Individuals with confirmed ischemic stroke based on of CT scan were included in the study. Demographic information included age, sex, history of smoking, place of residence, season of disease incidence, history of contraceptive use in women, history of hypertension, having high blood pressure at the onset of diabetes, hyperlipidemia, heart disease and patient weight. Finally, the collected data was analyzed using SPSS ver. 22. Results: The mean age of participants was 40.18 years. The mean weight, height, body mass index (BMI) were 79.83, 168.63, and 28.12, respectively. A total of 60.4% of the participants were male and 39.6% were female. Moreover, 66.9% were urban residents, 38.6% had complications in winter, 67% were smokers, and 50% used contraceptives. The history of hypertension, diabetes, hyperlipidemia, and heart disease was seen in 69%, 49.7, 66%, and 73.6% of cases, respectively. Also, 53.8% of patients had high blood pressure upon admission. Conclusion: The present study showed that a history of heart disease and a history of hypertension in the past and nicotine use are very common in people with stroke. Considering the above mentioned epidemiological factors, it is recommended to prioritize the mentioned factors when identifying new cases


2019 ◽  
Vol 23 (1) ◽  
pp. 17-26
Author(s):  
Evgenij А. Protasov ◽  
Arseniy A. Velikanov

Russian health care faces the task of reducing mortality and disability of patients with coronary heart disease. This problem could be solved with outpatient rehabilitation and secondary prevention. Despite of numerous evidences of their effectiveness there is no publicly available system for the management of patients with the addition of non-drug treatments to drug therapy in our country. This is due to the lack of material and technical base, a sufficient number of specialists, underestimation of this method by the physicians and low patients’ motivation. A special problem is the patient behavior itself, which can be described as “irrational”.


2021 ◽  
Vol 8 (11) ◽  
pp. 1724
Author(s):  
Keerthana Medidhi ◽  
Abhishek Sabbani

Background: Hypertension is a major risk factor for critical diseases like coronary heart disease, stroke, kidney disease etc. Hence adequate control of blood pressure is of utmost importance to prevent these complications. Objectives of the study was to study the clinical, laboratory and complication profile of patients with hypertensionMethods: A hospital based cross sectional study was carried out among 30 known cases of hypertension. Investigations/measurements like Blood pressure, body mass index, lipid profile, fasting blood sugar were done for all cases.Results: Majority belonged to age group of >60 years (56.7%). Males were more (70%) than females (30%). About 60% had hypertension for >5 years. Only 26.7% were normal weight and remaining were either overweight or obese. The 56.7% admitted that they consumed alcohol. The 76.7% were non-smokers and only 10% were tobacco chewers. The 63.3% had family history of hypertension. Diabetes was the most common co morbidity associated with hypertension in 16.7% of the cases. The 10% each had coronary heart disease, and kidney disease. Mean levels of total cholesterol was 163.93; mean level of triglyceride was 159.53; mean level of HDL was 44.4; mean level of LDL was 84.76; mean level of Fasting blood sugar was 110.66; mean Systolic blood pressure was 134.66 and mean diastolic blood pressure was 86. Majority i.e., 90% were taking treatment for hypertension regularly while only 10% were not taking it regularly Conclusions: Hypertensives were elderly and males were more affected with hypertension than females. Majority were hypertensives for more than five years. Diabetes was the most common co morbidity. Blood pressure was under control as majority were taking treatment regularly


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