Abstract P115: How Many Coronary Heart Disease Deaths In Poland In 2020 Might Be Prevented By Further Reductions In Population Risk Factor Levels?

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Piotr Bandosz ◽  
Maria Guzman-Castillo ◽  
Simon Capewell ◽  
Tomasz Zdrojewski ◽  
Julia Critchley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Smoking Prevalence ◽  
Mortality Rates ◽  
Mortality Reduction ◽  
Scenario Reduction ◽  
Saturated Fats ◽  
Changes In Risk

Background: Poland has experienced one of the most dramatic declines in coronary heart disease (CHD) mortality rates in recent decades. This decline reflects the use of evidence based treatments and, crucially, population wide changes in diet. Our aim is to explore the potential for further gains in Poland by achieving population wide reductions in smoking, dietary salt and saturated fat intake and physical inactivity levels. Methods: A validated and updated policy model was used to forecast potential decreases in CHD deaths by 2020 as consequence of lifestyle and dietary changes in the population. Data from the most recent Polish risk factor survey was used for the baseline (2011). We modeled two different policy scenarios regarding possible future changes in risk factors: A) conservative scenario: reduction of smoking prevalence and physically inactivity rates by 5% between 2011 and 2020, and reduction of dietary consumption of energy from saturated fats by 1% and of salt by 10%. B) ideal scenario: reduction of smoking and physically inactivity prevalence by 15%, and dietary reduction of energy from saturated fats by 3% and of salt by 30%. We also conducted extensive sensitivity analysis using different counterfactual scenarios of future mortality trends. Results: Baseline scenarios. By assuming continuing declines in mortality and no future improvements in risk factors the predicted number of CHD deaths in 2020 would be approximately 13,600 (9,838-18,184) while if mortality rates remain stable, the predicted number of deaths would approximate 22,200 (17,792-26,688). Conservative scenario. Assuming continuing declines in mortality, small changes in risk factors could result in approximately 1,500 (688-2,940) fewer deaths. This corresponds to a 11% mortality reduction. Under the ideal scenario, our model predicted some 4,600 (2,048-8,701) fewer deaths (a 34% mortality reduction). Reduction in smoking prevalence by 5% (conservative scenario) or 15% (ideal scenario) could result in mortality reductions of 4.5% and 13.8% respectively. Decreases in salt intake by 10% or 30% might reduce CHD deaths by 3.0% and 8.6% respectively. Replacing 1% or 3% of dietary saturated fats by poly-unsaturates could reduce CHD deaths by 2.6% or 7.7% Lowering the prevalence of physically inactive people by 5%-15% could decrease CHD deaths by 1.2%-3.7%. Conclusion: Small and eminently feasible population reductions in lifestyle related risk factors could substantially decrease future number of CHD deaths in Poland, thus consolidating the earlier gains.

Risk Factors for Cardiorespiratory and All Cause Mortality in Men and Women in Urban Scotland: 15 Year Follow Up

1995 ◽  
Vol 40 (4) ◽  
pp. 108-112 ◽  
Author(s):  
G.C.M. Watt ◽  
C.L. Hart ◽  
D.J. Hole ◽  
G.D. Smith ◽  
C.R. Gillis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Respiratory Disease ◽  
Mortality Rates ◽  
Respiratory Impairment ◽  
Study Objective ◽  
Men And Women ◽  
All Cause Mortality

Study objective: To describe the relationship between risk factors, risk behaviours, symptoms and mortality from cardiorespiratory diseases in an urban area with high levels of socioeconomic deprivation. A cohort study of 15,411 men and women aged 45–64, comprising 80% of the general population of Paisley and Renfrew, Scotland. Outcomes: Mortality after 15 years from coronary heart disease(ICD 410–4), stroke(ICD 430–8), respiratory disease(ICD 460–519) and all causes. Main results: Mortality rates from all causes were 19% in men aged 45–49, 31% in men aged 50–54, 42% in men aged 55–59 and 57% in men aged 60–64. The rates are considerably higher than those reported in previous UK prospective studies. For women the rates were 12%, 18%, 25% and 38% respectively. In general men and women showed similar relationships between risk factor levels and mortality rates. People in manual occupations had higher mortality rates. Raised levels of systolic and diastolic blood pressure were associated with increased coronary, stroke and all cause mortality rates. Plasma cholesterol had no such association with all cause mortality rates. High and low levels of body mass index were associated with higher mortality rates than intermediate levels. A relationship between short stature and increased mortality rates was observed in men and women. FEV1 expressed as a percentage of the expected value showed the strongest relationship with mortality rates, particularly for respiratory disease, but also for deaths from coronary heart disease, stroke and all causes. Conclusions A similar pattern of relationship between risk factor levels and mortality rates exists in men and women in Renfrew and Paisley. Respiratory impairment as measured by FEV 1% predicted appears to be the most likely explanation of the observed high all cause mortality rates in this population.

Mortality and associated risk factors in diabetics

1985 ◽  
Vol 110 (4_Suppl) ◽  
pp. S21-S26 ◽  
Author(s):  
R. J. Jarrett ◽  
M. J. Shipley
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mortality Risk ◽  
Mortality Rates ◽  
Potential Risk Factors ◽  
Diabetic Population ◽  
Associated Risk Factors ◽  
The Relationship

Summary. In 168 male diabetics aged 40-64 years participating in the Whitehall Study, ten-year age adjusted mortality rates were significantly higher than in non-diabetics for all causes, coronary heart disease, all cardiovascular disease and, in addition, causes other than cardiovascular. Mortality rates were not significantly related to known duration of the diabetes. The predictive effects of several major mortality risk factors were similar in diabetics and non-diabetics. Excess mortality rates in the diabetics could not be attributed to differences in levels of blood pressure or any other of the major risk factors measured. Key words: diabetics; mortality rates; risk factors; coronary heart disease. There are many studies documenting higher mortality rates - particularly from cardiovascular disease -in diabetics compared with age and sex matched diabetics from the same population (see Jarrett et al. (1982) for review). However, there is sparse information relating potential risk factors to subsequent mortality within a diabetic population, information which might help to explain the increased mortality risk and also suggest preventive therapeutic approaches. In the Whitehall Study, a number of established diabetics participated in the screening programme and data on mortality rates up to ten years after screening are available. We present here a comparison of diabetics and non-diabetics in terms of relative mortality rates and the influence of conventional risk factors as well as an analysis of the relationship between duration of diabetes and mortality risk.

scholarly journals Blended collaborative care in the secondary prevention of coronary heart disease improves risk factor control: Results of a randomised feasibility study

2019 ◽  
Vol 19 (2) ◽  
pp. 134-141 ◽  
Author(s):  
Lena Bosselmann ◽  
Stella V Fangauf ◽  
Birgit Herbeck Belnap ◽  
Mira-Lynn Chavanon ◽  
Jonas Nagel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Collaborative Care ◽  
Intervention Group ◽  
Psychosocial Risk ◽  
Control Group ◽  
Risk Factor Control ◽  
Care Intervention

Background: Risk factor control is essential in limiting the progression of coronary heart disease, but the necessary active patient involvement is often difficult to realise, especially in patients suffering psychosocial risk factors (e.g. distress). Blended collaborative care has been shown as an effective treatment addition, in which a (non-physician) care manager supports patients in implementing and sustaining lifestyle changes, follows-up on patients, and integrates care across providers, targeting both, somatic and psychosocial risk factors. Aims: The aim of this study was to test the feasibility, acceptance and effect of a six-month blended collaborative care intervention in Germany. Methods: For our randomised controlled pilot study with a crossover design we recruited coronary heart disease patients with ⩾1 insufficiently controlled cardiac risk factors and randomised them to either immediate blended collaborative care intervention (immediate intervention group, n=20) or waiting control (waiting control group, n=20). Results: Participation rate in the intervention phase was 67% ( n=40), and participants reported high satisfaction ( M=1.63, standard deviation=0.69; scale 1 (very high) to 5 (very low)). The number of risk factors decreased significantly from baseline to six months in the immediate intervention group ( t(60)=3.07, p=0.003), but not in the waiting control group t(60)=−0.29, p=0.77). Similarly, at the end of their intervention following the six-month waiting period, the waiting control group also showed a significant reduction of risk factors ( t(60)=3.88, p<0.001). Conclusion: This study shows that blended collaborative care can be a feasible, accepted and effective addition to standard medical care in the secondary prevention of coronary heart disease in the German healthcare system.

Asymmetric and symmetric dimethylarginine in patients presenting with risk factors for coronary heart disease

Open Medicine ◽  
2012 ◽  
Vol 7 (5) ◽  
pp. 659-664
Author(s):  
Marina Ilic ◽  
Radmila Pavlovic ◽  
Gordana Lazarevic ◽  
Tatjana Cvetkovic ◽  
Gordana Kocic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Middle Aged ◽  
Control Groups ◽  
Symmetric Dimethylarginine ◽  
Patient Groups

AbstractThe aim of the present study was to investigate asymmetric (ADMA) and symmetric dimethylarginine (SDMA) production in patients presenting with one or more risk factor (RF) for coronary heart disease (CHD). Patients and methods: Overall, 113 participants were enrolled in the study, including 45 patients presenting with risk for CHD (27 male and 18 female; aged 55.9 ± 6.4 years), 30 sex and age-matched middle-aged healthy controls (16 male and 14 female; aged 56.3 ± 8.4 years), and 38 young healthy controls (38 male; aged 24.6 ± 3.9 years). Results: No significant differences for ADMA and SDMA were recorded between patients groups presenting with risk for CHD. However, ADMA and SDMA were significantly higher in all examined patient groups (≥3 and 1–2 RF, hypertensive and non-hypertensive, obese and non-obese, diabetics and non-diabetics) compared with both control groups (middle-aged and young controls) (p<0.001). ADMA significantly correlated with SDMA in ≥3 RF (p<0.05), hypertensive (p<0.05), non-obese (p<0.05), non-diabetics (p<0.01), as well in middle-aged (p<0.05) and young controls (p<0.001). Conclusion: Significantly higher ADMA and SDMA were found between patients presenting with risk for CHD (≥3 and 1–2 RF, hypertensive and nonhypertensive, obese and non-obese, diabetics and non-diabetics) and healthy, middle-aged and young controls. ADMA significantly correlated with SDMA in ≥3 RF, hypertensive, non-obese and non-diabetic patients, as well as in middle-aged and young controls.

Longitudinal Evolution of Risk of Coronary Heart Disease in Systemic Lupus Erythematosus

2012 ◽  
Vol 39 (5) ◽  
pp. 968-973 ◽  
Author(s):  
IGOR KARP ◽  
MICHAL ABRAHAMOWICZ ◽  
PAUL R. FORTIN ◽  
LOUISE PILOTE ◽  
CAROLYN NEVILLE ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Blood Glucose ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Chd Risk ◽  
Over Time

Objective.To produce evidence on the longitudinal evolution of risk factors for coronary heart disease (CHD) in patients with systemic lupus erythematosus (SLE).Methods.Based on data for 115 patients from the Montreal General Hospital Lupus Clinic (1971–2003) and for 4367 control subjects from the Framingham Offspring Study (1971–1994), we investigated the temporal evolution of total serum cholesterol, systolic blood pressure (SBP), body mass index (BMI), blood glucose, and estimated risk for CHD (reflecting the balance of changes in different risk factors). In analyses limited to patients with SLE, we assessed the effect of SLE duration on each risk factor, adjusting for age, calendar time, sex, baseline level of the risk factor, and medication use. Next, we assessed how the adjusted difference in the values of the risk factors between SLE and controls changes over time.Results.Among patients with SLE, longer disease duration was independently associated with higher SBP and blood glucose levels. Compared with controls, these patients appeared to have accelerated rates of increase in total cholesterol, blood glucose, and overall estimated CHD risk. The rate of increase in BMI was lower in patients with SLE than in controls.Conclusion.Elevated CHD risk in patients with SLE appears to be at least partially mediated by accelerated increases in some CHD risk factors, longitudinal trajectories of which increasingly diverge over time from those of population controls.

scholarly journals Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors

2023 ◽  
Vol 83 ◽  
Author(s):  
R. Muzaffar ◽  
M. A. Khan ◽  
M. H. Mushtaq ◽  
M. Nasir ◽  
A. Khan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Logistic Regression ◽  
Risk Factor ◽  
Heart Disease ◽  
Independent Risk Factor ◽  
Plasma Homocysteine ◽  
History Of ◽  
The Mean ◽  
Conventional Risk Factors

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.

Cholesterol and stroke

1999 ◽  
Vol 9 (1) ◽  
pp. 1-12 ◽  
Author(s):  
SN Evans ◽  
MD Fotherby
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Clinical Trials ◽  
Risk Factor ◽  
Heart Disease ◽  
Serum Cholesterol ◽  
Intervention Studies ◽  
The Elderly

Stroke and coronary heart disease (CHD) share many risk factors, suggesting at least some similarities in pathogenesis. It is therefore surprising that the role of one of the major risks for CHD, dyslipidaemia, remains so contentious as a risk factor for stroke. Because of a lack of good clinical trials, conflicting views have been expressed on the association of lipids, primarily serum cholesterol and its subfractions, with stroke disease and the merits of preventing stroke by lowering cholesterol. Many of the issues involved are intimately related to those of managing dyslipidaemia in the elderly. If stroke occurred as commonly below the age of 65 as above this age it is likely that the necessary epidemiological and intervention studies would already have been undertaken.

A systems biology and proteomics-based approach identifies SRC and VEGFA as biomarkers in risk factor mediated coronary heart disease

2016 ◽  
Vol 12 (8) ◽  
pp. 2594-2604 ◽  
Author(s):  
Alexandar V. ◽  
Pradeep G. Nayar ◽  
R. Murugesan ◽  
Shajahan S. ◽  
Jayalakshmi Krishnan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Systems Biology ◽  
Molecular Mechanisms

We propose a novel systems biology approach that relates causative genes, interactomes and pathways to elucidate the risk factors mediating the molecular mechanisms and biomarkers of coronary heart disease for feasible diagnosis.

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