Results of an epidemiological study of ischemic heart disease and arterial hypertension among industrial workers

1982 ◽  
Vol 63 (2) ◽  
pp. 16-19
Author(s):  
V. V. Trusov ◽  
I. A. Shinkareva ◽  
R. A. Plastinina ◽  
N. A. Oleinik ◽  
B. N. Sapranov ◽  
...  

Abstract. Epidemiological studies have been carried out in order to clarify the frequency of various risk factors and their combinations in IHD and arterial hypertension, which provided valuable information for the development of scientifically based measures for mass and individual primary and secondary prevention of IHD and arterial hypertension. Effective primary prevention measures at a young age should occupy a special place in the health improvement system for workers and employees.

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Abdeslam Bouzeman ◽  
Maxime De Guillebon ◽  
Guillaume Duthoit ◽  
Magalie Ladouceur ◽  
Raphael Martins ◽  
...  

Background: Tetralogy of Fallot (TOF) is the most frequent form of congenital heart disease managed by EP physicians for potential ICD. However, few studies have reported long-term outcomes of TOF patients with ICD. Methods: Between 2005 and 2014, all TOF patients with ICD in 17 French centers were enrolled in a specific evaluation aiming to determine characteristics at implantation as well as outcomes (overall mortality, appropriate ICD therapies, and device-related complications). Results: Overall 78 patients (45±13 years, 64% males) were enrolled. A majority of patients were implanted in the setting of secondary prevention (73%), whereas the remaining (27%) in primary prevention. Among the latest group, known risk factors for sudden cardiac death were: severe pulmonary regurgitation (30%,) prior palliative shunt (50%), syncope with unknown origin (25%), inducible ventricular tachycardia (45%), QRS duration ≥180ms (18%), non-sustained ventricular tachycardia (25%), and documented sustained supra ventricular tachycardia (45%).Overall, patients implanted in the setting of primary prevention presented with a mean of 3.1±1.4 risk factors. After a mean follow-up of 4.9±3.8 years, 35 patients (45%) experienced at least one appropriate therapy (25% in the primary prevention group compared to 53% in the secondary prevention group), giving annual-incidences of 6.9% (95%CI 0.14-13.7) and 21.3% (12.4-30.3) respectively (P=0,01). The mean time between ICD implantation and the first appropriate therapy was 2.2±3.2 years, without significant differences between primary and secondary prevention. Overall, ≥one ICD-related complication occurred in 30 patients (38%), including inappropriate shock (n=9), major pocket hematoma (n=1), lead dysfunction (n=12), infection (n=4), shoulder algodystrophia (n=2), device failure or dislodgement needing reintervention (n=2). Eventually, four patients were transplanted (5%), and six patients (8%) died during the course of follow-up. Conclusions: Considering relatively long-term follow-up, patients with TOF and ICDs experience high rates of appropriate ICD therapies, in both primary and secondary prevention. Major ICD-related complications remain, however, high.


2001 ◽  
Vol 7 (1) ◽  
pp. 28-32
Author(s):  
Mary Seed ◽  
R Mandeno ◽  
C Le Roux

This review summarises current evidence for therapeutic options for hyperlipidaemia in post menopausal women. The two situations in which treatment is recommended are: 1. Primary prevention, which requires assessment of total risk factors for coronary heart disease. a) Statins. AFCAPS/TEXCAPS is the only randomised controlled trial (RCT) to include women. Fewer coronary heart disease (CHD) events, but no difference in mortality was found. b) Hormone replacement therapy (HRT). While there are numerous reports of positive observational epidemiological studies for HRT, there are no completed RCTs. There is little evidence for statin use in women except for familial hypercholesterolaemia. HRT is therefore not only appropriate for its multiple effects on lipoproteins, vascular function and insulin sensitivity but also for prevention of osteoporosis. 2. Secondary prevention, to achieve target total and low density lipoprotein (LDL) cholesterol. a) Statins. The major measurable effect of these drugs is to reduce total and LDL cholesterol. In the RCTs 4S, CARE and LIPID, where 20% of subjects were female, CHD events, but neither CHD mortality nor total mortality were significantly reduced in women. b) HRT. Data available from two RCTs using conjugated equine oestrogens and medroxyprogesterone acetate show no benefit. Other studies of HRT have been observational and positive. The effects of treatment on lipoproteins with statins, HRT and the combination have been investigated. In secondary prevention for hyperlipidaemic women to achieve cholesterol <5 and LDL<3 mmol/L statins will be first choice, with HRT a possible addition for its other benefits on cardiovascular risk factors. Choice of HRT medication. The route of administration will affect specific risk factors, eg, oral oestrogen reduces Lp(a) and LDL, increases HDL, while the transdermal route is less effective at reducing Lp(a) and LDL but does not increase triglyceride. Both routes reduce fibrinogen, factor VII and adhesion molecules and improve blood flow. The choice of progestogen will also affect cardiovascular risk factors. The most important lipid risk factors in women are HDL, triglyceride and Lp(a). The risk associated with raised triglyceride and LDL is offset by high HDL. Thus, in women with risk factors in primary prevention, theoretically oral HRT with a non-androgenic progestogen is likely to be of most benefit. However, since long-term adherence to therapy is important in reducing cardiovascular risk, the individual's choice of route and type of HRT is paramount.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Stranges ◽  
A Takeda ◽  
N Martin ◽  
L Ellis ◽  
D Wijesekara ◽  
...  

Abstract Background Observational studies have confirmed the benefits of adherence to a Mediterranean dietary pattern on cardiovascular disease (CVD) but the randomised controlled trial (RCT) evidence is limited. Objective To determine the effectiveness of a Mediterranean-style diet for the primary and secondary prevention of CVD. Methods We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Web of Science, DARE, HTA, NHS EED and trial registers (September 2018). We selected RCTs in healthy adults and adults at high risk of CVD (primary prevention) and those with established CVD (secondary prevention). Both of the following key components were required for our definition of a Mediterranean-style diet: high monounsaturated/saturated fat ratio and a high intake of plant based foods, including fruits, vegetables, and legumes. The intervention could be dietary advice, provision of relevant foods or both. The comparison group received either no intervention, minimal intervention, usual care or another dietary intervention. Outcomes included clinical events and CVD risk factors. We included only studies with follow-up periods of 3 months or more. Results Overall, 30 RCTs (12,461 participants randomised) and 7 ongoing trials met our inclusion criteria, whereas 22 primary prevention trials and 6 secondary prevention trials were analysed. Low quality evidence shows little or no effect of the PREDIMED (7747 randomised) intervention (advice to follow a Mediterranean diet plus supplemental extra virgin olive oil or tree nuts) compared to a low fat diet on CVD mortality (HR 0.81 (95% CI 0.5, 1.32)) or total mortality (HR 1.0 (95% CI 0.81, 1.24)) over 4.8 years. There was however a reduction in the number of strokes with the PREDIMED intervention (HR 0.6 (95% CI 0.45, 0.8), moderate quality evidence). For secondary prevention, in the Lyon Diet Heart Study (605 CVD patients), there was moderate quality evidence of a reduction in CVD mortality (HR 0.35 (95% CI 0.15, 0.82)) and total mortality (HR 0.44 (95% CI 0.21, 0.92)) with the intervention, over 46 months. For CVD risk factors, in primary prevention trials, there was low quality evidence for a possible small reduction in total cholesterol (−0.16 mmol/L (95% CI −0.32, 0.00), and moderate quality evidence for a reduction in SBP (−2.99 mmHg (95% CI −3.45, −2.53)) and DBP (−2.0 mmHg (95% CI −2.29, −1.71)). In secondary prevention trials, there was moderate quality evidence of no effect of a Mediterranean-style diet on lipid levels and low or very low quality evidence for blood pressure. Conclusions Despite the relatively large number of studies included in this review, there is still some uncertainty regarding the effects of a Mediterranean-style diet on clinical endpoints and CVD risk factors for both primary and secondary prevention. The ongoing studies may provide more certainty in the future.


2021 ◽  
Vol 102 (5) ◽  
pp. 736-746
Author(s):  
T A Mulerova ◽  
M Yu Ogarkov ◽  
D P Tsygankova ◽  
Yu V Kazachek ◽  
O M Polikutina ◽  
...  

Aim. To assess the indigenous small population of the Shor people in terms of the ethnic-specific development of cardiovascular diseases and their risk factors during the epidemiological studies in the Mountain Shoria. Methods. The study was carried included the indigenous and non-indigenous population of the Mountain Shoria during two different time periods: the first period (19982002) 1215 people (550 indigenous Shors and 665 non-indigenous people) and the second period (20132017) 1409 people (901 and 508, respectively). The prevalence of cardiovascular risk factors, arterial hypertension (AH) and ischemic heart disease (CHD) was studied. In the second period of the study, the genotype frequencies of the genes ACE (I/D, r 4340), AGT (c.803TC, rs699), AGTR1 (A1166C, rs5186), ADRB1 (c.145AG, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (c.677CT, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a) and their associations with arterial hypertension were identified. There was data on organ damage obtained among patients with high blood pressure (left ventricular myocardial hypertrophia, carotid arteries intima-media complex thickening, albumin level). Results. The first period of the studies showed that the Shors differed from the incoming population in an extremely low prevalence of lipid metabolism disorders, obesity, and an almost complete absence of diabetes mellitus. At the same time, there was a high prevalence of tobacco smoking and alcohol consumption. The second period of the studies demonstrated significant differences between different ethnic cohorts according to the genetic passport towards a more favorable profile among the indigenous people. However, the Shor people with arterial hypertension had a more severe course of hypertensive disease, defined as frequent organ damage. In addition, the profile of a patient with coronary heart disease differed depending on the place of residence, in urban or rural. Epidemiological studies contribute to the acquisition of new knowledge about different ethnic groups, their lifestyles and agricultural practices, regions of residence, and the features of candidate gene polymorphism. This provides valuable material for individualizing the prevention and treatment of diseases. Conclusion. Ethnicity makes adjustments to the patient's profile; understanding the ethnic specificity allows developing targeted preventive measures, thereby preserving the peoples health.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P.S Yang ◽  
Y Kang ◽  
H.D Park ◽  
J.H Sung ◽  
B Joung

Abstract Background and objectives There are few nationwide data about the mortality outcome after implantable cardioverter-defibrillator (ICD) implantation. The aim of this study was to evaluate the mortality outcome after ICD implantation according to indication for implantation (primary vs. secondary prevention) and underlying etiology (non-ischemic vs. ischemic heart disease) with a nationwide cohort data of Korea. Methods During the period from January 1, 2008 to December 31, 2017, 3,558 patients (mean age, 67.7±11.4 years) with newly-implanted ICD who were aged 19 years or older were identified by 50-percents random sampling from the Korean National Health Insurance Service database. Results Patients with primary and secondary prevention ICD were 1,097 (30.8%) and 2,461 (69.2%), respectively. Patients with non-ischemic and ischemic heart disease were 2,487 (69.9%) and 1,071 (30.1%), respectively. Overall all-cause mortality was 20.4% during the follow-up period (mean 24 months). The mortality rates in patients with primary and secondary prevention ICD were 26.2% and 17.9%, respectively. The mortality rates in patients with non-ischemic and ischemic heart disease were 16.1% and 30.4%, respectively. In Kaplan-Meier estimates of survival according to both indication for implantation and underlying etiology, the best prognostic group was patients with secondary prevention ICD and having non-ischemic etiology. The worst prognostic group was patients with primary prevention ICD and having ischemic etiology. The survival probability was below 50% (45.2%) 5 years after ICD implantation in patients with primary prevention ICD and having ischemic etiology. Conclusions In Korean nationwide data, patients with primary prevention ICD and having ischemic etiology show the worst prognosis. About half of these patients died of any cause within five years. Funding Acknowledgement Type of funding source: None


2013 ◽  
Vol 25 (3) ◽  
pp. 118-128 ◽  
Author(s):  
Florian Rehbein ◽  
Dirk Baier

In recent years, a variety of epidemiological studies have provided empirical data on the prevalence of video game addiction (GA) in different age groups. However, few studies investigated the causes of GA and could explain why video game playing as a widespread phenomenon leads to a comparatively small percentage of addicted players. Additionally, the existing longitudinal studies mainly consider psychological trait variables and neglect the possible explanatory value of predictors in socialization regarding media availability, media use, and family and everyday school life. In this paper, the results of a two-wave longitudinal study comprising a sample of students from Grades 4 to 9 (N = 406) are presented. The data show that 15-year-old video game addicts had already exhibited a number of specific risk factors at the age of 10. Students from single-parent families seem to be particularly at risk, as are students with low experienced school well-being and with a weaker social integration in class. The data also indicate that problematic use of video games in childhood increases the risk of GA in adolescence. Male students are especially vulnerable for developing GA. The results of this study are an important contribution to understanding risk factors for GA in adolescents, thereby laying the groundwork for effective prevention measures.


2020 ◽  
Vol 18 (5) ◽  
pp. 523-531
Author(s):  
N. A. Maхimovich ◽  
◽  
A. V. Luksha ◽  

Background. In modern society, there is an intensive increase in the incidence of arterial hypertension among young people, which is mainly due to lifestyle characteristics and related risk factors.Objective: to analyze the results of scientific researches of domestic and foreign authors regarding the study of risk factors in the development of arterial hypertension in children.Material and methods. A qualitative analysis of the current literature data on the risk factors for arterial hypertension and its prevention has been carried out.Results. It has been established that the occurrence of arterial hypertension in childhood is due to not only hereditary, but also a number of environmental risk factors.Conclusions. Further researches are needed to study new and established risk factors that must be considered when conducting primary prevention of the disease in children at high risk.


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