Abstract 13050: Gender Differences in the Implementation of Secondary Prevention in Patients With Coronary Heart Disease: Results From the EUROASPIRE IV Survey

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kornelia Kotseva ◽  
Delphine De Smedt ◽  
David Wood ◽  
Dirk De Bacquer ◽  
Keyword(s):  
Blood Pressure ◽  
Gender Differences ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Central Obesity ◽  
Ldl Cholesterol ◽  
Cross Sectional ◽  
Therapeutic Goals ◽  
Risk Factor Management ◽  
Coronary Syndrome

Objective: To describe gender differences in lifestyle and risk factor management, and the use of cardioprotective drug therapies in patients with coronary heart disease in Europe. Methods: The EUROASPIRE IV survey was a cross-sectional study carried out under the auspices of the European Society of Cardiology, EURObservational Research Programme in 2012-2013 in 78 centers in 24 European countries. Consecutive patients <80 years after acute coronary syndrome or revascularization were identified from hospital records and interviewed and examined at least 6 months later using standardized methods and instruments. Results: A total of 7998 patients (24.4% females) were interviewed on average 16 months after having experienced a cardiac event. Women were older (mean age 66.3 years [SD 9.0] vs 63.2 [9.7], p<0.001), had a lower level of education, and had more often unstable angina (14.4% vs 9%, p<0.001) at inclusion than men. Comparing women with men, the prevalence of the risk factors were as follows (p-values adjusted for age and center): current smoking 11.1% vs 17.6% (p<0.001), obesity (BMI ≥ 30 kg/m2) 43.8% vs 35.6% (p<0.001), central obesity (waist circumference ≥ 102 cm in men or ≥ 88 cm in women) 75.2% vs 52.8% (p<0.001), raised blood pressure (BP ≥ 140/90 mmHg, ≥ 140/80 mmHg in patients with diabetes) 43.8% vs 42.4%, (p=0.662), elevated LDL-cholesterol (≥ 1.8 mmol/l) 84.4% vs 79.2% (p<0.001) and self reported diabetes 30.1% vs 25.7% (p=0.013). Reported use of prophylactic drug therapies for the same comparison was: antiplatelets 92.4% vs. 94.3% (p=0.102); beta-blockers 82.5% vs. 82.6% (p=0.858); ACE inhibitors/ARBs 74.6% vs. 75.3% (p=0.187); and statins 83.5% vs. 86.4% (p=0.039). The therapeutic control of blood pressure, LDL-cholesterol and diabetes (HbA1c < 7 mmol/L) was: 53.7% vs 53.1% (p=0.171), 17.3% vs 22.3% (p<0.001) and 49.2% vs 53.8% (p=0.015), respectively. Conclusion: The results show that women with coronary heart disease have higher prevalence of obesity, central obesity, LDL-cholesterol and self-reported diabetes than men. Despite similarities in pharmacological treatment women reach less often than men the therapeutic goals of LDL-cholesterol after acute coronary event or revascularization.

P3424Gender differences in the implementation of CVD prevention In patients with coronary disease: Results from the EUROASPIRE V Survey

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Kotseva ◽  
G De Backer ◽  
D De Bacquer ◽  
D Grobbee ◽  
A Hoes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Disease ◽  
Central Obesity ◽  
Ldl Cholesterol ◽  
Lifestyle Changes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Factor Management ◽  
Coronary Syndrome

Abstract Introduction EUROASPIRE V was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2016–2017 in 27 European countries Purpose To describe gender differences in lifestyle and risk factor management, and the use of cardioprotective drug therapies in patients with coronary heart disease in Europe. Methods Patients <80 years with coronary disease (CABG, PCI or an acute coronary syndrome) were identified from the hospital medical records and interviewed and examined by trained staff ≥6 months and ≤2 years later using standardized methods including central laboratory measurements. Results A total of 8,261 (25.8% females), mean age 63.6 (SD 9.6) were interviewed, with a median time between the index event and interview 1.12 years (IR 0.82–1.56). Women were older (mean age 65.4 years [SD 9.2] vs 63.0 [9.7] and had a lower level of education than men.Comparing women with men, the prevalence of the risk factors were as follows: current smoking 12.8% vs 20.7%,obesity (BMI ≥30 kg/m2) 45.7% vs 34.9%, central obesity (waist circumference ≥102 cm in men or ≥88 cm in women) 78.0% vs 51.8%, raised blood pressure (BP ≥140/90 mmHg, ≥140/80 mmHg in patients with diabetes) 47.1% vs 46.0%, elevated LDL-cholesterol (≥1.8 mmol/l) 77.9% vs 68.5% and self reported diabetes 33.1% vs 28.0%. Reported use of prophylactic drug therapies for the same comparison was: antiplatelets 91.8% vs. 92.8%; beta-blockers 81.8% vs. 80.8%; ACE inhibitors/ARBs 75.0% vs. 75.3%; and statins 76.8% vs. 82.2%. The therapeutic control of blood pressure, LDL-cholesterol and diabetes (HbA1c <7 mmol/L) was: 48.2% vs 49.9%; 25.7% vs 34.1% and 48.5% vs 56.7%, respectively. Conclusions The results show that women with coronary disease have higher prevalence of obesity, central obesity, elevated LDL-cholesterol and self-reported diabetes than men. There were no differences in terms of blood pressure management. All coronary patients require professional support to make lifestyle changes and manage risk factors more effectivelyin order to reduce their risk of recurrent cardiovascular events. Acknowledgement/Funding ESC-EORP supported by Amgen, Eli Lilly, Pfizer, Sanofi, Ferrer and Novo Nordisk

scholarly journals Exploring the relationship between coronary heart disease and type 2 diabetes: a cross-sectional study of secondary prevention among diabetes patients

BJGP Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. bjgpopen18X101636 ◽  
Author(s):  
Bjørn Gjelsvik ◽  
Anh Thi Tran ◽  
Tore J Berg ◽  
Åsne Bakke ◽  
Ibrahimu Mdala ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Ldl Cholesterol ◽  
South Asians ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

BackgroundCoronary heart disease (CHD) and stroke are the major causes of death among people with diabetes.AimTo describe the prevalence and onset of CHD and stroke among patients with type 2 diabetes mellitus (T2DM) in primary care in Norway, and explore the quality of secondary prevention.Design & settingA cross-sectional study of data was undertaken from electronic medical records (EMRs) of 10 255 patients with T2DM in general practice. The study took place in five counties of Norway (Oslo, Akershus, Rogaland, Hordaland, and Nordland). Quality of care was assessed based on national guideline recommendations.MethodSummary statistics with adjustments and binary logistic regression models were used.ResultsIn total, 2260 patients (22.1%) had CHD and 759 (7.4%) had stroke. South Asians had significantly more CHD than ethnic Norwegians (29.5%, 95% confidence interval [CI] = 26.1 to 33.0 versus 21.5%, CI = 20.6 to 22.3) and other ethnic groups, and experienced onset of CHD or stroke at a mean of 7 years before Norwegians. In 47.9% of the patients, CHD was diagnosed before T2DM. Treatment target for low-density lipoprotein (LDL) cholesterol was reached for 30.0% and for systolic blood pressure (SBP) for 65.1% of the patients with CHD. Further, 20.9% of patients with CHD were present smokers, and only 5.0% of patients reached all four treatment targets (no smoking, HbA1c ≤7.0%, SBP <135 mmHg, LDL-cholesterol <1.8 mmol/l).ConclusionThe diagnosis of CHD preceded the diagnosis of T2DM in half of the patients. The prevalence of CHD was highest and onset earlier among ethnic South Asians. More intensive treatment of lipids, blood pressure, and smoking are needed in patients with T2DM and CHD.

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 ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Lipid Lowering ◽  
Community Based ◽  
Cross Sectional ◽  
History Of ◽  
Cvd Prevention

<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.

scholarly journals Dyslipidemia: A Trigger for Coronary Heart Disease in Romanian Patients with Diabetes

Metabolites ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 195 ◽  
Author(s):  
Mihnea-Alexandru Găman ◽  
Matei-Alexandru Cozma ◽  
Elena-Codruța Dobrică ◽  
Nicolae Bacalbașa ◽  
Ovidiu Gabriel Bratu ◽  
...  
Keyword(s):  
Gender Differences ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Statin Prescription ◽  
And Gender ◽  
Internal Medicine Clinic

Previous studies have reported age and gender disparities in the occurrence and therapeutic approach of dyslipidemia and (or) coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate these differences in Romanian patients with T2DM. A cross-sectional, observational, retrospective study was conducted using the medical records of T2DM patients who attended the outpatient facility of the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest, Romania for routine check-ups in a six-month period. We analyzed the records of 217 diabetic patients (mean age 69 ± 11 years; 51.15% women). We found no significant gender differences in the occurrence of dyslipidemia, CHD or CHD + dyslipidemia or in terms of statin prescription. However; patients aged 65 years or older were significantly more affected by dyslipidemia, CHD or CHD + dyslipidemia, versus subjects aged <65 years. Further, they were more likely to be prescribed statin therapy (p < 0.0001 for all). Statins were prescribed to 67.24% of the patients with dyslipidemia; 61.01% of the subjects with CHD; and to 91.48% of the patients who had both conditions. e recorded no gender differences in the occurrence of CHD and (or) dyslipidemia in Romanian T2DM patients. Patients aged 65 years or older had a higher prevalence of CHD and/or dyslipidemia, and were more likely to be prescribed statins, versus younger counterparts. However, many T2DM patients with CHD and (or) dyslipidemia were undertreated: Nearly 33% of the subjects with dyslipidemia, and nearly 40% of the ones with CHD were not prescribed statins.

Risk Factors of Coronary Heart Disease among Civil Employees of a Tertiary Level Hospital

2020 ◽  
Vol 11 (1) ◽  
pp. 22-28
Author(s):  
Md Saydur Rahman ◽  
Nurun Nahar
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Heart Diseases ◽  
Positive Family History ◽  
Risk Behaviour ◽  
Educational Status ◽  
Normal Weight ◽  
Cross Sectional

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

scholarly journals A hospital based cross sectional study on clinical, laboratory and complications profile of patients with hypertension

2021 ◽  
Vol 8 (11) ◽  
pp. 1724
Author(s):  
Keerthana Medidhi ◽  
Abhishek Sabbani
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Kidney Disease ◽  
Blood Sugar ◽  
Clinical Laboratory ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Co Morbidity

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

scholarly journals Atypical nature of coronary artery disease in women: a proposal for measurement and classification

2015 ◽  
Vol 33 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Viviana Marycel Céspedes Cuevas
Keyword(s):  
Coronary Heart Disease ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Symptom Management ◽  
Discriminant Validity ◽  
Management Strategies ◽  
Measurement Instrument ◽  
Symptom Experience ◽  
Cross Sectional ◽  
Coronary Syndrome

<p><strong>Objective:</strong> To identify subgroups of women with Acute Coronary Syndrome according to symptom experience: perception, evaluation and response, based on the Symptom Management Conceptual Model.</p><p><strong>Methodology:</strong> Quantitative, descriptive, exploratory, cross-sectional study. The sample was made of 380 women positively diagnosed with Acute Coronary Syndrome, hospitalized in two institutions in Bogotá, Colombia. A measurement instrument was designed and validated.</p><p><strong>Results:</strong> Final instrument was made of 37 items that reported content validity, scale validity, discriminant validity, and construct validity. A Cronbach’s Alpha coefficient of 0,76 was obtained, which guarantees homogeneity in the measurement<br />according to the Maximum Validity-Maximum Reliability Model.<br />A total of 11 subgroups of women with Acute Coronary Syndrome were identified, those were characterized by atypical coronary heart disease symptomatology, evaluation processes<br />related to extra-cardiac causes and inadequate symptom management strategies. It was possible to demonstrate that psychosocial factors, previous coronary heart disease and delays were variables making a significant influence on the components of symptom experience.</p><p><strong>Conclusions:</strong> Women with Acute Coronary Syndrome, belonging to the 11 subgroups that were identified<br />and studied, showed atypical symptoms. The instrument designed features a proven psychometric quality; it was valid, reliable, and useful for clinical research and practice.</p>

scholarly journals Long-term moderately elevated LDL-cholesterol and blood pressure and risk of coronary heart disease

PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0200017 ◽  
Author(s):  
Peter Ueda ◽  
Pablo Gulayin ◽  
Goodarz Danaei
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ldl Cholesterol
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