scholarly journals Adherence to prescription guidelines and achievement of treatment goals among persons with coronary heart disease in Tromsø 7

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elisabeth Pedersen ◽  
Beate Hennie Garcia ◽  
Kjell H. Halvorsen ◽  
Anne Elise Eggen ◽  
Henrik Schirmer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Practice ◽  
Ldl Cholesterol ◽  
Antihypertensive Drugs ◽  
Goal Achievement ◽  
Treatment Goal ◽  
Blood Pressure Goal ◽  
Treatment Goals

Abstract Background Adherence to clinical practice guidelines for coronary heart disease (CHD) reduces morbidity, mortality and treatment costs. We aimed to describe and compare adherence to prescription guidelines for persons with CHD, and explore its association with treatment goal achievement. Method We included all participants reporting myocardial infarction, angina, percutaneous coronary intervention and/or coronary artery bypass surgery in the seventh wave of the Tromsø Study (2015–2016, n = 1483). Medication use and treatment goal measures (blood pressure, low-density lipoprotein (LDL)-cholesterol and HbA1c) were compared to clinical practice guidelines on secondary CHD prevention. Propensity score matched logistic regression was used to assess the association between the use of antihypertensive drugs and achievement of treatment goal for blood pressure, and the use of lipid-lowering drugs (LLDs) and achievement of treatment goal for LDL-cholesterol. Results The prevalence of pharmacological CHD treatment was 76% for LLDs, 72% for antihypertensive drugs and 66% for acetylsalicylic acid. The blood pressure goal (< 140/90 mmHg, < 140/80 mmHg if diabetic) was achieved by 58% and the LDL-cholesterol goal (< 1.8 mmol/l or < 70 mg/dL) by 9%. There was a strong association between using LLDs and achieving the treatment goal for LDL-cholesterol (OR 14.0, 95% CI 3.6–54.7), but not between using antihypertensive drugs and blood pressure goal achievement (OR 1.4, 95% CI 0.7–2.7). Conclusion Treatment goal achievement of LDL-cholesterol and blood pressure was low, despite the relatively high use of LLDs and antihypertensive drugs. Further research is needed to find the proper actions to increase achievement of the treatment goals.

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.

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

scholarly journals First results of the Russian database of international prospective observational registry variability of blood pressure in patients with hypertension

2014 ◽  
Vol 11 (4) ◽  
pp. 9-16
Author(s):  
O D Ostroumova
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Practice ◽  
Antihypertensive Therapy ◽  
Antihypertensive Effect ◽  
Fixed Combination ◽  
International Registry ◽  
First Results ◽  
Real Clinical Practice

The article presents the results of an analysis of the Russian part of the international registry of variability in blood pressure. It is shown that in a real clinical practice antihypertensive therapy reduces inter-visit variability of systolic and diastolic blood pressure. It has been found that the fixed combination of perindopril arginine / amlodipine has antihypertensive effect and its impact on the variability of systolic blood pressure exceeds that for other modes of antihypertensive therapy. Revealed patterns are characteristic also for subgroups of patients with a combination of hypertension and coronary heart disease, hypertension and diabetes.

scholarly journals Patients with a Combination of Atrial Fibrillation and Chronic Heart Failure in Clinical Practice: Comorbidities, Drug Treatment and Outcomes

2022 ◽  
Vol 17 (6) ◽  
pp. 816-824
Author(s):  
M. M. Loukianov ◽  
S. Yu. Martsevich ◽  
Yu. V. Mareev ◽  
S. S. Yakushin ◽  
E. Yu. Andreenko ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Practice ◽  
Cerebral Stroke ◽  
Cardiovascular Pharmacotherapy ◽  
Hemorrhagic Complications

Aim. To assess in clinical practice the structure of multimorbidity, cardiovascular pharmacotherapy and outcomes in patients with a combination of atrial fibrillation (AF) and chronic heart failure (CHF) based on prospective registries of patients with cardiovascular diseases (CVD).Materials and Methods. The data of 3795 patients with atrial fibrillation (AF) were analyzed within the registries RECVASA (Ryazan), RECVASA FP (Moscow, Kursk, Tula, Yaroslavl), REGION-PO and REGION-LD (Ryazan), REGION-Moscow, REGATA (Ryazan). The comparison groups consisted of 3016 (79.5%) patients with AF in combination with CHF and 779 (29.5%) patients with AF without CHF. The duration of prospective observation is from 2 to 6 years.Results. Patients with a combination of AF and CHF (n=3016, age was 72.0±10.3 years; 41.8% of men) compared with patients with AF without CHF (n=779, age was 70.3±12.0 years; 43.5% of men) had a higher risk of thromboembolic complications (CHA2DS2-VASc – 4.68±1.59 and 3.10±1.50; p<0.001) and hemorrhagic complications (HAS-BLED – 1.59±0.77 and 1.33±0.76; p<0.05). Patients with a combination of AF and CHF significantly more often (p<0.001) than in the absence of CHF were diagnosed with arterial hypertension (93.9% and 83.8%), coronary heart disease (87.9% and 53,5%), myocardial infarction (28.4% and 14.0%), diabetes mellitus (22.4% and 7.7%), chronic kidney disease (24.8% and 16.2%), as well as respiratory diseases (20.1% and 15.3%; p=0.002). Patients with AF in the presence of CHF, compared with patients without CHF, were more often diagnosed with a permanent form of arrhythmia (49.3% and 32.9%; p<0.001) and less often paroxysmal (22.5% and 46.2%; p<0.001) form  of  arrhythmia.  Ejection  fraction  ≤40%  (9.3%  and  1.2%;  p<0.001),  heart  rate  ≥90/min  (23.7% and 19.3%; p=0.008) and blood pressure ≥140/90 mm Hg (59.9% and 52.2%; p<0.001) were recorded with AF in the presence of CHF more often than in the absence of CHF. The frequency of proper cardiovascular pharmacotherapy was higher, albeit insufficient, in the presence of CHF (64.9%) than in the absence of it (56.1%), but anticoagulants were prescribed less frequently when AF and CHF were combined (38.8% and  49, 0%; p<0.001). The frequency of unreasonable prescription of antiplatelet agents instead of anticoagulants was 52.5% and 33.3% (p<0.001) in the combination of AF, CHF and coronary heart disease, as well as in the combination of AF with coronary heart disease but without CHF. Patients with AF and CHF during the observation period compared with those without CHF had higher mortality from all causes (37.6% and 30.3%; p=0.001), the frequency of non-fatal cerebral stroke (8.2% and 5.4%; p=0.032) and myocardial infarction (4.7% and 2.5%; p=0.036), hospitalizations for CVD (22.8% and 15.5%; p<0.001).Conclusion. Patients with a combination of AF and CHF, compared with the group of patients with AF without CHF, were older, had a higher risk of thromboembolic and hemorrhagic complications, they were more often diagnosed with other concomitant cardiovascular and chronic noncardiac diseases, decreased left ventricular ejection fraction, tachysystole, failure to achieve the target blood pressure level in the presence of arterial hypertension. The frequency of prescribing proper cardiovascular pharmacotherapy was higher, albeit insufficient, in the presence of CHF, while the frequency of prescribing anticoagulants was less. The  incidence of mortality from all causes, the development of non-fatal myocardial infarction   and cerebral stroke, as well as the incidence of hospitalizations for CVDs were higher in AF associated with CHF.

scholarly journals Determinants of Coronary Heart Disease Incidence among Indonesian Hajj Pilgrims Hospitalized in Saudi Arabia in 2019

2021 ◽  
Vol 9 (E) ◽  
pp. 798-804
Author(s):  
Juniarty Naim ◽  
Wahiduddin Wahiduddin ◽  
Masni Masni ◽  
Ridwan Amiruddin ◽  
Irwandy Irwandy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Logistic Regression ◽  
Saudi Arabia ◽  
Heart Disease ◽  
Ldl Cholesterol ◽  
Multiple Logistic Regression ◽  
Cholesterol Levels ◽  
Sugar Levels

BACKGROUND: Cardiovascular diseases (CVDs) are the main causes of death worldwide, including in the hajj pilgrims. Coronary heart disease (CHD) is the most common CVDs in Indonesian hajj pilgrims hospitalized in Saudi Arabia. AIM: This study aimed to determine the determinants of the CHD incidence among Indonesian hajj pilgrims hospitalized in Saudi Arabia in 2019. METHODS: This study was an observational analytic study with a case–control design. The study was conducted in Makassar using data from the integrated Hajj computerized system in the health sector (siskohatkes) Hajj Health Center (Puskeshaji) in January–June 2021. Cases were pilgrims hospitalized in Saudi Arabia with a diagnosis of CHD, about 186 people, and controls were pilgrims hospitalized with diagnoses other than CVDs. Selection of controls by matching age and sex with a ratio of 1:1. The determinants analyzed included education, high blood pressure, high blood sugar levels, high low-density lipoprotein (LDL) cholesterol levels, excess body mass index (BMI), and smoking. Data analysis was using the STATA program with an odds ratio (OR) test and multiple logistic regression. RESULTS: The most respondents were 65 years (48.39%), female respondents, about 61.83%. Most respondents’ education was in elementary school, about 31.99%. Multivariate analysis showed that high blood pressure (OR = 2.32, 95% confidence index [CI] = 1.50–3.57), high blood sugar levels (RO = 1.90, 95% CI = 1.06–3.40), high LDL cholesterol levels (RO = 1.82, 95% CI = 1.15–2.88), and excess BMI (RO = 1.73, 95% CI = 1.07–2.68) were risk factors for the CHD incidence. However, education and smoking were not risk factors for CHD. CONCLUSION: By multiple logistic regression analyzes, the study revealed that the probability of CHD when having those four risk factors was 85.69%.

scholarly journals HUBUNGAN TEKANAN DARAH DENGAN KADAR KOLESTEROL LDL(Low Density Lipoprotein) PADA PENDERITA PENYAKIT JANTUNG KORONERDI RSUP.Dr.M.DJAMIL PADANG

2018 ◽  
Vol 5 (2) ◽  
pp. 129-132
Author(s):  
ERAWATI ERAWATI
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Cholesterol Levels ◽  
A Value ◽  
Moderate Relationship

Coronary heart disease is a disease caused by narrowing of the coronary arteries of the heart. This happens because of its high cholesterol levels can cause atherosclerosis in blood vessels Hypercholesterolemia mainly occurs when increased production of LDL (Low Density Lipoprotein). As a result of the narrowing of blood vessels blood flow to the heart will be disrupted, causing symptoms of chest pain that is a typical symptom of coronary heart disease. Chronic atherosclerosis can cause blood flow to the heart to be disturbed, so that the left ventricle must pump stronger to produce enough force to push blood through the atherosclerotic vascular system that can lead to increased systolic and diastolic blood pressure resulting in hypertension. This study included descriptive analytic research using cross sectional approach, is dependent variable (incidence of coronary heart disease) and indenpendent variable (blood pressure and LDL cholesterol level) collected at the same time. The study was conducted on September 10, 2016 - April 4, 2017 at the Central Laboratory and Heart Ward RSUP.Dr. M. Djamil Padang. The sampling technique used is purposive sampling, that is the technique of determining the sample with certain consideration. Of 36 samples of patients with coronary heart disease (CHD) showed a correlation between systolic blood pressure with LDL cholesterol level has a value of 0.585> 0.05 which states there is a moderate relationship between the two variables, and has significant significance of 0.00 <0, 05 and Ha are received. The correlation between diastolic blood pressure and LDL levels has a value of 0,507> 0,05 which states there is a moderate relationship between the two variables, and has significant value of 0.02 significance <0.05 and Ha is accepted. Based on these results then there is a significant relationship between blood pressure with LDL cholesterol levels in the blood.

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