scholarly journals Rational of Current Practice of Prescribing Statin to Treat Dyslipidaemia as Primary Prevention of Coronary Heart Disease in Elderly People

1970 ◽  
Vol 1 (1) ◽  
pp. 45-55
Author(s):  
Asif Manwar ◽  
Michael Y Henein ◽  
Md Nurul Amin ◽  
Khaled Mohsin
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Primary Prevention ◽  
Statin Therapy ◽  
Elderly People ◽  
Elderly Population ◽  
Heart Diseases ◽  
The Elderly ◽  
Coronary Heart Diseases

Background: The efficacy of statin therapy in preventing both primary and secondary coronary heart diseases in young and middle aged people is well known and well supported by numbers of landmark clinical trials. Literatures addressing reduction of cholesterol level in elderly (septogenarians & octogenarians) as primary prevention strategy for coronary heart diseases are scarce. The elderly population rarely suffer from primary heart attack and as such routine prescribing of statin to treat dyslipidaemia as primary prevention of coronary heart disease is controversial, particularly when there are reports that statin therapy in elderly population causes cancer, haemorrhagic stroke, dementia and so on. The present study was aimed at answering these questions in order to help formulating a separate guideline for statin therapy in elderly. Methods: The present study reviewed literatures of recent and recent past origin. A systematic literature search of MEDLINE, EMBASE, CINAHL, Web of Science, CANCERLIT and the Cochrane Systematic Review Database have been used to identify randomized clinical trials of statin use with the main focus on primary or secondary end point of CHD, acute coronary syndrome (ACS), cardiac death, overall death, stroke and cancer diagnosis or cancer death. To be included in this review, (1) the entire study subjects or a sub-group were of age 55 years or more (2) had a mean (or median) duration of patient follow-up of at least 1 year, (3) enrolled a minimum of 100 patients, and (4) reported data on the incidence of either cancer diagnosis or cancer death in the elderly population. Conclusions: The study concludes that statin therapy in elderly people may not provide additional benefit in the prevention of primary cardiovascular diseases or death due to primary cardiovascular events. Though most of the studies ruled out excess risk of cancer or other noncardiovascular events, their probability cannot be entirely ignored. However, there is report that addition of statin to the existing drug schedule of elderly subjects does not cause drug interaction. Large-scale, randomized trial on truly representative population with long term follow up will provide authentic data to answer the question whether statin therapy in elderly people with dyslipidaemia can prevent primary heart diseases. Key words: Statin; primary prevention; coronary heart disease; dyslipidemia; elderly people. Ibrahim Card Med J 2011; 1(1):45-55

Transversal and longitudinal studies of risk factors for coronary heart disease in the elderly population of Sa˜o Paulo

1994 ◽  
Vol 109 (1-2) ◽  
pp. 15
Author(s):  
M.S. Cendoroglo ◽  
T.L.R. Martinez ◽  
L.E.S. Almeida Pinto ◽  
F.R. Gonçalves ◽  
T.E.C. Rosa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Longitudinal Studies ◽  
Elderly Population ◽  
The Elderly

scholarly journals Observational data for comparative effectiveness research: An emulation of randomised trials of statins and primary prevention of coronary heart disease

2011 ◽  
Vol 22 (1) ◽  
pp. 70-96 ◽  
Author(s):  
Goodarz Danaei ◽  
Luis A García Rodríguez ◽  
Oscar Fernández Cantero ◽  
Roger Logan ◽  
Miguel A Hernán
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Primary Prevention ◽  
Statin Therapy ◽  
Observational Data ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Randomised Trial ◽  
Effectiveness Research ◽  
Intention To Treat

This article reviews methods for comparative effectiveness research using observational data. The basic idea is using an observational study to emulate a hypothetical randomised trial by comparing initiators versus non-initiators of treatment. After adjustment for measured baseline confounders, one can then conduct the observational analogue of an intention-to-treat analysis. We also explain two approaches to conduct the analogues of per-protocol and as-treated analyses after further adjusting for measured time-varying confounding and selection bias using inverse-probability weighting. As an example, we implemented these methods to estimate the effect of statins for primary prevention of coronary heart disease (CHD) using data from electronic medical records in the UK. Despite strong confounding by indication, our approach detected a potential benefit of statin therapy. The analogue of the intention-to-treat hazard ratio (HR) of CHD was 0.89 (0.73, 1.09) for statin initiators versus non-initiators. The HR of CHD was 0.84 (0.54, 1.30) in the per-protocol analysis and 0.79 (0.41, 1.41) in the as-treated analysis for 2 years of use versus no use. In contrast, a conventional comparison of current users versus never users of statin therapy resulted in a HR of 1.31 (1.04, 1.66). We provide a flexible and annotated SAS program to implement the proposed analyses.

scholarly journals Interactions between the Gut Microbiome, Lung Conditions, and Coronary Heart Disease and How Probiotics Affect These

2021 ◽  
Vol 22 (18) ◽  
pp. 9700
Author(s):  
Trudy M. Wassenaar ◽  
Valentina A. Juncos ◽  
Kurt Zimmermann
Keyword(s):  
Cardiovascular Disease ◽  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Immune Cells ◽  
Gut Microbiome ◽  
Chronic Conditions ◽  
Heart Diseases ◽  
Short Chain Fatty Acids ◽  
Coronary Heart Diseases

The importance of a healthy microbiome cannot be overemphasized. Disturbances in its composition can lead to a variety of symptoms that can extend to other organs. Likewise, acute or chronic conditions in other organs can affect the composition and physiology of the gut microbiome. Here, we discuss interorgan communication along the gut–lung axis, as well as interactions between lung and coronary heart diseases and between cardiovascular disease and the gut microbiome. This triangle of organs, which also affects the clinical outcome of COVID-19 infections, is connected by means of numerous receptors and effectors, including immune cells and immune-modulating factors such as short chain fatty acids (SCFA) and trimethlamine–N–oxide (TMAO). The gut microbiome plays an important role in each of these, thus affecting the health of the lungs and the heart, and this interplay occurs in both directions. The gut microbiome can be influenced by the oral uptake of probiotics. With an improved understanding of the mechanisms responsible for interorgan communication, we can start to define what requirements an ‘ideal’ probiotic should have and its role in this triangle.

scholarly journals Predoperatsionnaya terapiya statinamiu patsientov s ishemicheskoy bolezn'yu serdtsa

2011 ◽  
Vol 2 (1) ◽  
pp. 51-54
Author(s):  
Ol'ga Leonidovna Barbarash ◽  
Yuliya Vyacheslavovna Bayrakova ◽  
Evgeniya Mikhaylovna Kurguzova
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Statin Therapy ◽  
Bypass Surgery ◽  
Heart Diseases ◽  
Coronary Bypass ◽  
Ischemic Heart ◽  
Coronary Bypass Surgery ◽  
Ischemic Heart Diseases

Summary. The need for statins in patients with acute and chronic forms of coronary heart disease is now beyond doubt. However, there is still a view that from the perspective of safety it is necessary to cancel statins before a surgery and reinstitute them after a surgery. This review examines the feasibility and safety of preoperative statin therapy in patients with ischemic heart diseases before planned coronary bypass surgery.

scholarly journals PENDEKATAN DIAGNOSIS DAN TATALAKSANA GANGGUAN MOOD PADA USIA LANJUT

2021 ◽  
Vol 6 (2) ◽  
pp. 131
Author(s):  
Huwainan Nisa Nasution ◽  
Hadiq Firdausi
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mood Disorders ◽  
Aging Process ◽  
Elderly Population ◽  
The Elderly ◽  
Early Therapy ◽  
Mood Changes ◽  
Detection And Diagnosis ◽  
Early Detection And Diagnosis

Gangguan mood rentan diderita para penderita berusia lanjut. Statistik menunjukkan, terjadi peningkatan presentasi gangguan ini terutama pada penduduk lanjut usia. Hal ini kemungkinan disebabkan oleh gejala post power syndrome yang menyebabkan para lansia menjadi stres dan depresi. Penyebab lainnya yang dapat mencetuskan adalah penyakit komorbid yang menyertai kemudian menimbulkan pergantian mood yang cepat. Penyakit diabetes, tekanan darah tinggi, dan jantung koroner misalnya, diduga menyebabkan penderita merasa hilang kekuatan, kesulitan menyesuaikan diri, hingga akhirnya depresi. Kejadian bunuh diri pada usia lanjut yang mengalami gangguan mood juga dapat terjadi hampir setiap hari. Pentingnya deteksi dan diagnosis sejak dini merupakan hal yang penting demi mendapatkan terapi lebih dini. Gangguan mood pada usia lanjut bukanlah hal yang natural terkait proses penuaan, melainkan suatu gangguan  patologis yang dapat diterapi.Kata kunci: gangguan mood, depresi, manik, usia lanjut, geriatri. ABSTRACTMood disorders are susceptible to elderly sufferers. Statistics show, there is an increase in the presentation of mood disorder, especially in the elderly population. This is probably caused by the symptoms of post power syndrome which causes the elderly to become stressed and depressed. Other causes that can trigger are comorbid diseases that accompany and then cause rapid mood changes. Diabetes, hypertension, and coronary heart disease, for example, are thought to cause lost of strength, difficulty adjusting, and depression. Suicides in the elderly with mood disorders can also occur almost every day. The importance of early detection and diagnosis is important in order to get early therapy. Mood disorders in elderly are not a natural thing related to the aging process, but a pathological disorder that can be treated.Key words: mood disorders, depression, manic, elderly, geriatrics.

scholarly journals Dietary fiber and risk of coronary heart diseases

2021 ◽  
Vol 9 (3) ◽  
pp. 001-009
Author(s):  
Chibuzo Carole Nweze ◽  
Eneh Williams Nebechukwu ◽  
Muhammad Yusuf Bawa
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Weight Gain ◽  
Dietary Fiber ◽  
Heart Diseases ◽  
Short Chain Fatty Acids ◽  
The Body ◽  
Postprandial Blood Glucose ◽  
Soluble Fiber ◽  
Coronary Heart Diseases

Dietary fiber is the portion of plant-derived food that cannot be completely broken down by human digestive enzymes. Dietary fibers can be grouped generally by their solubility, viscosity, and fermentation, which affect how fibers are processed in the body. Dietary fiber has two main components: soluble fiber and insoluble fiber, which are components of plant foods, such as legumes, whole grains and cereals, vegetables, fruits, and nuts or seeds. Consumption of cereals, vegetable and fruit may lower the risk of coronary heart disease. Coronary heart disease involves the reduction of blood flow to the heart muscle due to build-up of plaque on the arteries of the heart. Dietary fiber makes three primary contributions: bulking, viscosity and fermentation. The bulking effect of some fibers reduces constipation and the risk of colon disease because they absorb water, which increases bulking and promotes regularity. Viscosity effects on fibers reduce the absorption of cholesterol and other nutrients because of the formation of gels that attenuate postprandial blood glucose and lipid rises. The formation of gels also slows gastric emptying, maintaining levels of satiety and contributing towards less weight gain. In the fermentation process, the bacteria GIT helps to digest fiber through a process of microbial fermentation to generate short chain fatty acids like acetate, propionate and butyrate. Butyrate binds to G-protein coupled receptors on the brush borders of intestinal lining and trigger a signal cascade that release GLP-1 and PYY. These peptides behave like hormones to trigger satiety. One of the reasons for eating fiber rich foods is because they promote satiety and prevent uncontrollable quest for food. People that eat food low in fiber experience over feeding issues. When people over eat they consume more calories leading to weight gain and that contributes to obesity. Obesity is the accumulation of fats in fat tissues. Excess fats are converted to cholesterol (LDL) which accumulates on the walls of the arteries and prevent the flow of blood to the heart. This is prevented when an individual consumes foods rich in fiber.

scholarly journals Prevalence of Coronary Heart Diseases Risk Factors among Healthcare Male Students in KSAU-HS Riyadh, Saudi Arabia

2021 ◽  
pp. 237-243
Author(s):  
Awadelkarim Abdulla Elneama ◽  
Aamir Omair ◽  
Abdullah Abdulhadi Alharbi ◽  
Alhommedi Shaker Alhabbad ◽  
Raed Awadh Alshehri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Fast Food ◽  
Heart Diseases ◽  
Blood Clot ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Coronary Heart Diseases ◽  
Physical Measurements

Background: Coronary heart disease (CHD) is a condition in which plaque builds up on the inner walls of coronary arteries and can lead to blood clot formation. It is the leading cause of death worldwide. Developing coronary heart disease takes long period and its risk factors can be found in young people. Objectives: Study of risk factors that contribute to the pathogenesis of coronary artery disease. Methods: A cross-sectional study was done at King Saud bin Abdul-Aziz University in Riyadh. Non-probability convenience sampling was used to select 151 health care students. The data was collected through questionnaire and physical measurements. The data was entered and analyzed by SPSS. Results: More than half of the students eat fruits one or less time per week which accounts for 53.6%. Moreover, 28.5% of them eat vegetables one time or less per week. Regarding healthy food containing healthy fat such as fish, 76.2% of the students include healthy fat food in their diet more than two times per week. The percentage of those who eat fast food and consume soft drinks is 80.8% and 70.2% more than two times per week respectively. Furthermore, the percentage of the students who are smokers, either currently or occasionally is 49%. Concerning physical activity, 31.3% of the students exercise more than two times weekly, and only 7.3% of the students watch TV more than four hours per day. On the other hand, the majority which accounts for 54.3% of the students use computer, laptop, or tablet more than four hours per day. Regarding premature CAD, 3.3% of the students reported positive and 16.2% of them reported positive for CHD family history. Finally, 1.3% of the found to have DM.

scholarly journals Association of Risk Factors of Coronary Heart Diseases and Socio-demographic Characteristics of Civil Employees of Combined Military Hospital Dhaka

2020 ◽  
Vol 15 (2) ◽  
pp. 175-177
Author(s):  
Md Saydur Rahman ◽  
FM Shamim Ahmmed ◽  
Farzana Zafreen
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Heart Diseases ◽  
Demographic Characteristics ◽  
Anthropometric Measurement ◽  
Military Hospital ◽  
High Income Group ◽  
Coronary Heart Diseases ◽  
Chd Risk Factors

Introduction: Risk factors are the most ruinous and mischievous ingredient to develop coronary heart diseases (CHD). Factors contributing to develop CHD and their associates are, therefore, of prime importance. It needs endless splurge to address the issue. Objectives: To identify the attributing risk factors and socio-demographic characteristics of coronary heart disease among civilian employees of Combined Military Hospital (CMH) Dhaka. Materials and Methods:  This observational study was conducted on 287 civil employees of CMH, Dhaka from September to December 2011. Data were collected by interview using questionnaire and check list which includes blood pressure measurement, anthropometric measurement and biochemical examinations. Results: Respondent’s age range was 23 to 59 years, educational level up to class VIII were 56.4 % and more than that were 36.6%, illiterate were 7%. Regarding income low, medium and high income group were 40.4%, 56.8% and 2.8% respectively. It was found that 68.6% had normal BP, 61.3% practices moderate exercise. Among the respondents 72.2% has got 1-5 risk factors of CHD. Risk factors (p <0.001) were significantly associated with age. Conclusion: This study finding is suggestive of association between risk factors of CHD and socio-demographic characteristics among the study population.  Care through motivation, avoidance of risk behaviour, addressing clinical conditions can resist risk factors of CHD thus coronary heart disease can be prevented. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 175-177

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