A qualitative exploration of the prescribing and use of statins in asymptomatic people in Ireland: A case of medicalisation, biomedicalisation and pharmaceuticalisation

2020 ◽  
pp. 136345932094606
Author(s):  
Paula Byrne ◽  
Órla O’Donovan ◽  
Susan M Smith ◽  
John Cullinan
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
High Cholesterol ◽  
Medical Problems ◽  
The Public ◽  
Socially Constructed ◽  
The Status ◽  
The Face ◽  
Notable Increase ◽  
Qualitative Exploration

There has been a notable increase in the use of statins in people without cardiovascular disease but who may be at risk in the future. The majority of statin users now fall into this category but little research has focused exclusively on this group. Debate has ensued regarding medicating asymptomatic people, and processes described variously as medicalisation, biomedicalisation and pharmaceuticalisation are used to explain how this happens. These overlapping and interrelated processes require issues to be ‘problemised’ as medical problems requiring medical solutions given the prevailing understandings of health, risk and disease. However, current understandings of risk and disease are not simply the result of technological and scientific advances, they are also socially constructed. We interviewed members of the public, GPs and others, and found that rather than high cholesterol being seen as one of several risk factors that contributes to heart disease, it tended to be promoted simplistically to the status of a disease needing treatment of itself. Statins were justified by those taking them as different to ‘unnecessary medicines’. However, some participants demonstrated resistance to statins, worried about over-medicalisation and deviated from accepted practices, indicating a complex ‘muddling through’ in the face of uncertainty.

Abstract P470: Heterogeneity In Prevalence Of Cardiovascular Disease Risk Factors Among Hispanic Ethnic Groups: Evidence From The 2010-2018 National Health Interview Survey

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Sabrina Elias ◽  
Ruth-alma N Turkson-ocran ◽  
Binu Koirala ◽  
Samuel Byiringiro ◽  
Hailey Miller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Ethnic Groups ◽  
Physical Inactivity ◽  
High Cholesterol ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Current Smoking ◽  
Hispanic Adults ◽  
Ethnic Subgroups

Introduction: Persons of Hispanic origin are a growing share of the U.S. population but include diverse ethnic groups with unique cultures, lifestyles, exposures, and countries of origin. Hispanics are disproportionately affected by cardiovascular disease (CVD) risk factors in comparison to non-Hispanics. However, few studies have examined the heterogeneity in their burden of CVD risk. Hypothesis: We hypothesized that there would be significant heterogeneity in the prevalence of CVD risk factors among ethnic subgroups of Hispanic adults. Methods: We used a cross-sectional design to examine the prevalence of CVD risk factors, defined per national guidelines, among Hispanic adults in the 2010-2018 National Health Interview Surveys. Generalized linear models using Poisson distribution were fitted to obtain adjusted predicted probabilities and risk of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and current smoking by Hispanic ethnic subgroup. Results: We included 185,511 participants with mean(±sd) age 31(0.2) years and 50% male. Most were Mexican (65.1%) whereas, few were Dominican (3.0%). Prevalence of hypertension (28.4%), diabetes (12.9%), high cholesterol (25.0%), and current smoking (6.1%) was highest among Puerto Ricans. Prevalence of overweight/obesity was highest among Mexicans (74.5%) and physical inactivity was highest among Dominicans (62.3%). Compared to Mexicans, Central Americans were less likely to smoke and have hypertension, overweight/obesity, and diabetes (ps<0.05). ( Table ) Conclusion: We observed striking heterogeneity in the prevalence of CVD risk factors across Hispanic ethnic subgroups, especially for diabetes, physical inactivity, and smoking. These results suggest that aggregating data on Hispanics may mask differences in CVD risk and hinder efforts to reduce health disparities in this population. Our findings provide actionable information on CVD risk factors for specific Hispanic ethnic subgroups.

scholarly journals ANALISIS PENYAKIT KARDIOVASKULAR MENGGUNAKAN METODE KORELASI PEARSON, SPEARMAN DAN KENDALL

2020 ◽  
Vol 10 (2) ◽  
pp. 119
Author(s):  
Yudi Eko Windarto
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Strong Relationship ◽  
High Cholesterol ◽  
Cholesterol Levels ◽  
Kendall Correlation ◽  
Analyze Data

Cardiovascular disease is a disease that is affected by the heart and blood vessels. There are several main risk factors that cause cardiovascular disease. Risk factors for cardiovascular disease include: high blood pressure, high cholesterol, diabetes, being overweight or obese, age, sex, smoking, and alcohol. The more risk factors you have, the greater the chance of causing cardiovascular disease. In this research, it was developed using the Spearman, Pearson and Kendall correlation methods to analyze data on cardiovascular disease patients. The results showed there was correlation between blood pressure (ap_hi and ap_lo), age, and cholesterol had a strong relationship with cardiovascular disease. Glucose and cholesterol levels also have a strong relationship between one another.

scholarly journals Evaluation of Risk Factors of Cardiovascular Diseases in Shimoga Population

2021 ◽  
pp. 263246362110016
Author(s):  
S. Parameshwara ◽  
B. Manjula ◽  
Geetha Bhaktha ◽  
K. Gurupadappa ◽  
G.K. Ranjith Kumar
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Alcohol Consumption ◽  
Food Habits ◽  
District Hospital ◽  
The Body ◽  
The Social ◽  
The Status ◽  
Study Population ◽  
Record Section

Background: The morbidity and mortality rate is increasing due to cardiovascular disease around the globe. This may be due to drastic changes in lifestyle, food habits, work, stress, genetic factors, and environmental conditions. The present study is undertaken to evaluate the risk factors of cardiovascular disease (CVD) in Shimoga region. Objective: Evaluation of risk factors of CVD in patients who admitted for treatment in McGann Teaching District Hospital, Shimoga. Methods: A retrospective study was conducted in Mc Gann's Teaching District Hospital, Shimoga from October 2017 to March 2018. Data about sociodemographic parameters such as age, sex, height, weight, smoking, the status of diabetes mellitus, type of occupation, and diet, tobacco, and alcohol consumption were retrieved from the medical record section and statistical analysis was done using Statistical Package for the Social Sciences (SPSS). Results: Out of 262 CVD cases, 60% were male and 40% were female. Based on the body mass index (BMI), 1.9% were underweight, 40.1% were normal, 34.4% were overweight, and 23.7% were obese. Sedentary (64.9%) lifestyle was significantly higher when compared to moderate (2.3%) and heavy (32.8%). Diabetes, smoking, tobacco, and alcohol consumption were seen to be significant while food custom was not significant among the study population ( P < .05). Conclusion: In our study, a higher percentage of CVD patients falls under normal BMI when compared to other studies. This may be due to lifestyle, socioeconomic status, ethnicity, and family hereditary. Further extensive studies should be carried out to find the main cause of CVD in Shimoga population.

scholarly journals Risk factors associated with cardiovascular disease among adult Nevadans

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247105
Author(s):  
Dieu-My T. Tran ◽  
Nirmala Lekhak ◽  
Karen Gutierrez ◽  
Sheniz Moonie
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Healthcare Providers ◽  
Population Based ◽  
Behavioral Risk ◽  
High Cholesterol ◽  
Cvd Risk ◽  
Cross Sectional ◽  
System Data

ObjectiveCardiovascular disease (CVD) remains the number one cause of death in the US and Nevada is ranked 11th highest for CVD mortality. The study sought to examine the association between self-reported risk factors and CVD presence among adult Nevadans, between years 2011 and 2017.MethodsThis is a cross-sectional, population-based study that utilized the 2011 and 2017 Nevada Behavioral Risk Factor Surveillance System data. Data were analyzed between 2019 and 2020.ResultsA total of 5,493 and 3,764 subjects in 2011 and 2017, respectively were included. BMI (overweight/obesity) remained the most prevalent CVD risk factor. The second most common CVD risk factor was high cholesterol, followed by hypertension. Compared to females, males were 1.64 times more likely to have reported CVD in 2011, which increased to 1.92 in 2017. Compared to non-smokers, everyday smokers were 1.96 times more likely in 2011 and 3.62 times more likely in 2017. Individuals with high cholesterol status were 2.67 times more likely to have reported CVD compared to those with normal levels in 2011. In 2011, individuals with hypertension were 3.74 times more likely to have reported CVD compared to those who did not have hypertension. This relationship increased its magnitude of risk to 6.18 times more likely in 2017. In 2011, individuals with diabetes were 2.90 times more likely to have reported CVD compared to those without the condition.ConclusionsPublic health and healthcare providers need to target preventable cardiovascular risk factors and develop recommendations and strategies locally, nationally, and globally.

scholarly journals Overemphasis on recovery inhibits community transformation and creates resilience traps

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Benjamin Rachunok ◽  
Roshanak Nateghi
Keyword(s):  
Risk Factors ◽  
Community Resilience ◽  
Status Quo ◽  
Housing Tenure ◽  
Community Transformation ◽  
The Status ◽  
The Face ◽  
Building Community ◽  
Climate Disasters

AbstractBuilding community resilience in the face of climate disasters is critical to achieving a sustainable future. Operational approaches to resilience favor systems’ agile return to the status quo following a disruption. Here, we show that an overemphasis on recovery without accounting for transformation entrenches ‘resilience traps’–risk factors within a community that are predictive of recovery, but inhibit transformation. By quantifying resilience including both recovery and transformation, we identify risk factors which catalyze or inhibit transformation in a case study of community resilience in Florida during Hurricane Michael in 2018. We find that risk factors such as housing tenure, income inequality, and internet access have the capability to trigger transformation. Additionally, we find that 55% of key predictors of recovery are potential resilience traps, including factors related to poverty, ethnicity and mobility. Finally, we discuss maladaptation which could occur as a result of disaster policies which emphasize resilience traps.

Abstract P151: Primary ASCVD Risk Associated With Undiagnosed Conditions Decreased Over NHANES 1999-2014

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
David R Nelson ◽  
Jessica A Davis
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
High Blood Pressure ◽  
The United States ◽  
High Cholesterol ◽  
Diabetes Status ◽  
Ascvd Risk ◽  
Over Time

Introduction: Atherosclerotic cardiovascular disease (ASCVD) is a general term for a group of diseases characterized by atherosclerosis that affect the heart and blood vessels. ASCVD is the leading cause of death in the United States contributing to at least 200,000 preventable deaths from heart disease and stroke each year. Cardiovascular disease, heart disease, and stroke mortality has declined since the year 2000, due to broader use of evidence-based therapies and changes to risk factors and lifestyle modifications, but the decline began to slow after 2011. Two main risk factors contributing to ASCVD are high blood pressure and high cholesterol. Efforts have been made to increase control of these factors at the population-level, however, only those who are diagnosed can be treated. While awareness has increased over time, there is still a significant contribution to ASCVD events from those who were undiagnosed but have high blood pressure, high cholesterol, and/or diabetes. Hypothesis: To assess how much of the total U.S. population ASCVD risk is undiagnosed from 1999-2014. Methods: The Pooled Cohort Equations assessed 10-year ASCVD risk, based on age, sex, race, total cholesterol, HDL level, systolic blood pressure, use of blood pressure medication, smoking status, and diabetes status. The undiagnosed risk of the primary risk population (age 40-79 years, without missing values for necessary cholesterol, blood pressure, and glucose measures) from 1999-2014 Continuous National Health and Nutrition Examination Survey (NHANES) was calculated based on self-report questions and clinical measures, after age, sex, race, smoking, and diagnosed risks were accounted for. Linear regression for complex survey data tested whether undiagnosed risk was changing over time. Results: Applying the ASCVD risk equation to the NHANES subset (n=8,763; weighted n=104,421,757), undiagnosed conditions were associated with 10% of the projected ASCVD events. That is, per 100,000 Americans in this subset, 7,747 ASCVD events were estimated over 10-years, and 800 were based on risk from undiagnosed diabetes, hypercholesterolemia, or hypertension. However, ASCVD risk associated with undiagnosed conditions over time decreased (p<0.001), from 1,169 per 100,000 in 1999-2000, to 642 per 100,000 in 2013-2014. Conclusions: NHANES creates a unique opportunity to quantify undiagnosed ASCVD risk in a nationally representative sample. Since 1999, a sizeable portion of the US primary ASCVD risk was based on undiagnosed conditions, however, this proportion of undiagnosed risk decreased over time.

The Rap Sheet

2018 ◽  
pp. 139-161
Author(s):  
Max Felker-Kantor
Keyword(s):  
Power Relations ◽  
Status Quo ◽  
Racial Justice ◽  
The Public ◽  
Intelligence Operations ◽  
The Status ◽  
The Face ◽  
Public Disorder ◽  
Definition Of ◽  
Police Abuse

The LAPD’s ability to maintain its independent partisan power in the face of procedural reforms and antipolice protest rested on its intelligence operations. Police spying, this chapter shows, targeted groups that challenged the status quo, none more so than anti–police abuse activists and movements for racial justice, using a capacious definition of “disorder.” But these same groups exposed the Public Disorder Intelligence Division’s surveillance operations (previously known as the Red Squad), leading to new regulations on the department’s activities, the end of the PDID, and the establishment of the department’s new intelligence unit, the Anti-Terrorist Division. The reforms, however, did not change the underlying power relations between the police and residents.

scholarly journals Why We Need Specialised Centres for Women’s Hearts: Changing the Face of Cardiovascular Care for Women

2021 ◽  
Vol 16 ◽  
Author(s):  
Martha Gulati ◽  
Cara Hendry ◽  
Biljana Parapid ◽  
Sharon L Mulvagh
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Comprehensive Approach ◽  
The Past ◽  
Specific Risk ◽  
The Face ◽  
Cardiovascular Care ◽  
Incremental Increase

Although cardiovascular disease (CVD) is the leading cause of mortality in women globally, cardiovascular care for women remains suboptimal, with poorer outcomes than for men. During the past two decades, there has been an incremental increase in research and publications on CVD in women, addressing sex-specific risk factors, symptoms, pathophysiology, treatment, prevention and identification of inequities in care. Nonetheless, once women have manifested CVD, they continue to have increasingly worse outcomes than men. An approach to addressing these global disparities has been the worldwide establishment of specialised centres providing cardiovascular care for women. These women’s heart centres (WHCs) allow a comprehensive approach to the cardiovascular care of women across the lifespan. The purpose of this article is to define the need for and role of these specialised centres by outlining sex-specific gaps in CVD care, and to provide guidance on components within WHCs that may be considered when establishing such programmes.

scholarly journals Subsidy/Donation and Performance of Microfinance Institutions

2019 ◽  
pp. 1-12
Author(s):  
Emengini Steve, Emeka ◽  
Onyeanu, Edith, Ogoegbunam ◽  
Anisiuba Chika, Anastasia ◽  
P. Ojiakor, Ijeoma ◽  
S. Ugwuegbe, Ugochukwu
Keyword(s):  
Stock Exchange ◽  
Tax Incentives ◽  
Secondary Source ◽  
Microfinance Institutions ◽  
The Public ◽  
Effective Performance ◽  
The Status ◽  
The Face ◽  
Microfinance Institution ◽  
And Performance

Subsidies and Donations are veritable tools that are supposed to engender effective performance in Microfinance institutions. On the face value, subsidies seem to be very positive but they can be counterproductive when related to their effects on performance, efficiency and self-sustainability of the Microfinance institutions. This paper therefore focuses on the assessment and review of issues relating to Subsidy/Donation and their effect on Performance of Microfinance Institutions (MFIs) in Nigeria. The methodology adopted is descriptive in nature and secondary source of data were made use of. Our review revealed mix results on the empirical findings of effect of subsidies/donations on performance of Microfinance institutions. This review shows that Subsidies can disincentive workers and managers, thereby creating moral hazard problems (Corruption and Financial impropriety). However, when applied to effect low borrowing costs and Tax incentives/concessions, it affects performance positively. The review also shows that subsidies ought to be used only in the startup phases of the life cycle and to be withdrawn when the Microfinance institution improves. Overall, to achieve the double bottom lines of social and financial sustainability obligations, funding structure in Microfinance should de-emphasise subsidy dependence and encourage market based principles and commercialisation. For effective corporate governance, big Microfinance institutions at the status of Banks and big NGOs should be mandated to disclose their accounts to the public and not just mere annual returns to the Central bank of Nigeria (This may involve quoting them in Nigeria Stock Exchange).

Sign in / Sign up

Export Citation Format

Share Document