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Hu B, Wang Y, Chen D, Feng J, Fan Y, Hou L. Temporal trends in the prevalence and death of ischemic heart disease in women of childbearing age from 1990 to 2019: a multilevel analysis based on the Global Burden of Disease Study 2019. Front Cardiovasc Med 2024; 11:1366832. [PMID: 38711792 PMCID: PMC11070499 DOI: 10.3389/fcvm.2024.1366832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024] Open
Abstract
Background Our objective is to describe the current prevalence and death of ischemic heart disease (IHD) in women of childbearing age (WCBA) at the global, regional, and national levels and to analyze its temporal trends from 1990 to 2019. Methods WCBA was defined as women aged 15-49 years. Estimates and 95% Uncertainty Intervals (UI) of IHD prevalence and death numbers for seven age groups were extracted from the 2019 Global Burden of Disease Study. The age-standardized prevalence and death rate (ASPR and ASDR) of IHD in WCBA was estimated using the direct age-standardization method. Joinpoint regression analysis was used to calculate average annual percent change (AAPC) to represent the temporal trends from 1990 to 2019. Results Between 1990 and 2019, the global ASPR of IHD experienced a 3.21% increase, culminating in 367.21 (95% UI, 295.74-430.16) cases per 100,000 individuals. Conversely, the ASDR decreased to 11.11 (95% UI, 10.10-12.30) per 100,000 individuals. In 2019, among the five sociodemographic index (SDI) regions, the highest ASPR was observed in the high-middle SDI region, whereas the highest ASDR was found in the low-middle SDI region. Regionally, the Caribbean reported the highest ASPR (563.11 per 100,000 individuals; 95% UI, 493.13-643.03), and Oceania reported the highest ASDR (20.20 per 100,000 individuals; 95% UI, 13.01-31.03). At the national level, Trinidad and Tobago exhibited the highest ASPR (730.15 per 100,000 individuals; 95% UI, 633.96-840.13), and the Solomon Islands had the highest ASDR (77.77 per 100,000 individuals; 95% UI, 47.80-121.19). Importantly, over the past three decades, the global ASPR has seen a significant increase [AAPC = 0.11%, 95% Confidence Interval (CI): 0.09-0.13; P < 0.001], while the ASDR has demonstrated a significant decreasing trend (AAPC = -0.86%, 95% CI: -1.11 to -0.61; P < 0.001). Air pollution, tobacco use, high systolic blood pressure, elevated body mass index, dietary risks, and high LDL cholesterol have been identified as the leading six risk factors for IHD-related deaths among WCBA in 2019. Conclusions Despite the significant decline in the global ASDR for IHD among WCBA over the last thirty years, the ASPR continues to escalate. We need to remain vigilant about the increased burden of IHD in WCBA. It calls for aggressive prevention strategies, rigorous control of risk factors, and the enhancement of healthcare coverage to mitigate the disease burden of IHD among WCBA in forthcoming years.
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Affiliation(s)
- Ben Hu
- Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, China
| | - Yan Wang
- Academy of Medical Sciences, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dong Chen
- Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Jun Feng
- Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Linlin Hou
- Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, China
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Qu C, Liao S, Zhang J, Cao H, Zhang H, Zhang N, Yan L, Cui G, Luo P, Zhang Q, Cheng Q. Burden of cardiovascular disease among elderly: based on the Global Burden of Disease Study 2019. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2024; 10:143-153. [PMID: 37296238 PMCID: PMC10904724 DOI: 10.1093/ehjqcco/qcad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The burden of elderly cardiovascular disease (CVD) has received increasing attention with population ageing worldwide. AIMS We reported on the global CVD burden in elderly individuals over 70, 1990-2019. METHODS AND RESULTS Based on the Global Burden of Disease Study 2019, elderly CVD burden data were analysed. Temporal burden trends were analysed with the joinpoint model. The slope index and concentration index were used to evaluate health inequality. From 1990 to 2019, the global elderly CVD incidence, prevalence, death, and disability-adjusted life year rates generally decreased. However, the current burden remains high. The rapid growth in burden in parts of sub-Saharan Africa and Asia is a cause for concern. Countries with a higher socio-demographic index (SDI) have generally seen a greater decrease in burden, while countries with a lower SDI have generally experienced increases or smaller declines in burden. Health inequality analysis confirmed that the burden was gradually concentrating towards countries with a low SDI. Among the different CVDs, ischaemic heart disease causes the greatest burden in elderly individuals. Most CVD burdens increase with age, but stroke and peripheral vascular disease show markedly different distributional characteristics. In addition, the burden of hypertensive heart disease shows an unusual shift towards high-SDI countries. High systolic blood pressure was consistently the leading risk factor for CVD among elderly individuals. CONCLUSION The burden of CVD in older people remains severe and generally tends to shift to lower-SDI countries. Policymakers need to take targeted measures to reduce its harm.
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Affiliation(s)
- Chunrun Qu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Sheng Liao
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Jingdan Zhang
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Hui Cao
- Department of Psychiatry, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, Hunan, China
| | - Hao Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Nan Zhang
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Luzhe Yan
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Gaoyuan Cui
- XiangYa School of Medicine, Central South University, Changsha, Hunan, China
| | - Peng Luo
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Qingwei Zhang
- Division of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Németh N, Boncz I, Pakai A, Elmer D, Horváth L, Pónusz R, Csákvári T, Kívés Z, Horváth IG, Endrei D. Inequalities in premature mortality from ischaemic heart disease in the WHO European region. Cent Eur J Public Health 2023; 31:120-126. [PMID: 37451245 DOI: 10.21101/cejph.a7287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 06/15/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Ischaemic heart disease (IHD) is one of the leading causes of premature mortality. Our aim was to analyse standardised premature mortality rates from IHD by geographical groups in the age group 45-59 years. METHODS We performed a retrospective, quantitative analysis of age-standardized mortality rates from IHD between 1990-2014 per 100,000 population in Western European (WE: N = 17), Eastern European countries (EE: N = 10), and countries of the former Soviet Union (fSU: N = 15) within the European Region of the World Health Organisation (WHO) based on data retrieved from the WHO European Mortality Database. Descriptive statistics, time series analysis and statistical tests were used for the analyses (ANOVA, Kruskal-Wallis test, Mann-Whitney test, paired t-test). RESULTS On average, age-standardized death rates (ASDR) from IHD per 100,000 population were the lowest in WE (men 1990: 143.67, 2014: 50.29; women 1990: 29.06, 2014: 9.89), and the highest in fSU (men 1990: 358.69, 2014: 253.25; women 1990: 99.78, 2014: 57.85). Between 1990 and 2014, all three groups experienced significant decrease in ASDR both in men and women (fSU: -29.39%, -42.02%; EE: -49.41%, -50.57%; WE: -64.99%, -65.97%, respectively) (p < 0.05). Between 1990 and 2004, ASDR decreased in WE in both sexes (p < 0.001), in EE among males (p = 0.032). Between 2004 and 2014, ASDR from IHD decreased significantly in both sexes in fSU and WE, in EE only among women (p < 0.05). CONCLUSIONS During the whole period analysed, ischaemic heart disease mortality significantly decreased in both sexes in all the groups.
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Affiliation(s)
- Noémi Németh
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Imre Boncz
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Annamária Pakai
- Faculty of Health Sciences, Szombathely Campus, University of Pecs, Pecs, Hungary
| | - Diána Elmer
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Lilla Horváth
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Róbert Pónusz
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Tímea Csákvári
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Zsuzsa Kívés
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pecs, Hungary
| | - Iván Gábor Horváth
- Heart Institute, Clinical Centre, Medical School, University of Pecs, Pecs, Hungary
| | - Dóra Endrei
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pecs, Hungary
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Safiri S, Karamzad N, Singh K, Carson-Chahhoud K, Adams C, Nejadghaderi SA, Almasi-Hashiani A, Sullman MJM, Mansournia MA, Bragazzi NL, Kaufman JS, Collins GS, Kolahi AA. Burden of ischemic heart disease and its attributable risk factors in 204 countries and territories, 1990-2019. Eur J Prev Cardiol 2021; 29:420-431. [PMID: 34922374 DOI: 10.1093/eurjpc/zwab213] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/28/2021] [Accepted: 12/05/2021] [Indexed: 11/12/2022]
Abstract
AIMS To report the prevalence, deaths, and disability-adjusted life years (DALYs) associated with ischemic heart disease (IHD) and its attributable risk factors in 204 countries and territories from 1990 to 2019, by age, sex, and socio-demographic index (SDI). METHODS AND RESULTS Ischemic heart disease was defined as acute myocardial infarction (MI) and chronic IHD (angina; asymptomatic IHD following MI). Cause of death ensemble modelling was used to produce fatality estimates. The prevalence of the non-fatal sequalae of IHD was estimated using DisMod MR 2.1. All estimates were presented as counts and age-standardized rates per 100 000 population. In 2019, IHD accounted for 197.2 million (177.7-219.5) prevalent cases, 9.1 million (8.4-9.7) deaths, and 182.0 million (170.2-193.5) DALYs worldwide. There were decreases in the global age-standardized prevalence rates of IHD [-4.6% (-5.7, -3.6)], deaths [-30.8% (-34.8, -27.2)], and DALYs [-28.6% (-33.3, -24.2)] from 1990 to 2019. In 2019, the global prevalence and death rates of IHD were higher among males across all age groups, while the death rate peaked in the oldest group for both sexes. A negative association was found between the age-standardized DALY rates and SDI. Globally, high systolic blood pressure (54.6%), high low-density lipoprotein cholesterol (46.6%), and smoking (23.9%) were the three largest contributors to the DALYs attributable to IHD. CONCLUSION Although the global age-standardized prevalence, death, and DALY rates all decreased. Prevention and control programmes should be implemented to reduce population exposure to risk factors, reduce the risk of IHD in high-risk populations, and provide appropriate care for communities.
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Affiliation(s)
- Saeid Safiri
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.,Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahid Karamzad
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kuljit Singh
- Department of Cardiology, Gold Coast University Hospital, Gold Coast, QLD, Australia.,Department of Medicine, Griffith University, Southport, QLD, Australia.,Department of Medicine, Bond University, Robina, QLD, Australia
| | - Kristin Carson-Chahhoud
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia.,School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Cobi Adams
- Department of Medicine, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Seyed Aria Nejadghaderi
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus.,Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Gary S Collins
- Centre for Statistics in Medicine, NDORMS, Botnar Research Centre, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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5
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Wang Z, Du A, Liu H, Wang Z, Hu J. Systematic Analysis of the Global, Regional and National Burden of Cardiovascular Diseases from 1990 to 2017. J Epidemiol Glob Health 2021; 12:92-103. [PMID: 34902116 PMCID: PMC8907368 DOI: 10.1007/s44197-021-00024-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/30/2021] [Indexed: 12/11/2022] Open
Abstract
Background Previous studies on the burden of cardiovascular diseases (CVDs) were mainly based on limited data of the study period or area, or did not include detailed risk factor analysis. Objective To investigate up-to-date temporal and regional trends and risk factors of mortality and disability-adjusted life years (DALYs) attributed to CVDs by age, sex, and disease throughout the world. Methods Data for the disease burden of CVDs in 195 countries and territories from 1990 to 2017, including mortality, DALYs, age-standardized mortality rates, and age-standardized DALY rates, were estimated from the Global Burden of Disease Study 2017. Risk factors attributable to deaths and DALYs for CVDs were also estimated using the comparative risk assessment framework. Results The number of deaths from CVDs increased by 48.62%, from 11.94 (95% UI 11.78–12.18) million in 1990 to 17.79 (17.53–18.04) million in 2017. However, the age-standardized mortality rate decreased by an average of − 1.45% (− 1.72% to − 1.18%) annually. After fluctuation in the expected age-standardized mortality rate of CVDs in most of the socio-demographic index (SDI) scale, these rates decrease rapidly for SDI values of 0.7 and higher. In 2017, metabolic risks accounted for 73.48% of deaths and 73.25% of DALYs due to CVDs, behavioral factors accounted for 63.23% of deaths and 66.71% of attributable DALYs. Conclusion CVDs remain a major global health burden due to the increment in death numbers and DALYs. Aging and the main risk factors are the main drivers of mortality and health loss. More attention to main risk factors should be paid with supportive health policies. Supplementary Information The online version contains supplementary material available at 10.1007/s44197-021-00024-2.
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Affiliation(s)
- Zhenkun Wang
- Department of Scientific Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Aihua Du
- Department of Scientific Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Hong Liu
- Department of Scientific Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Ziwei Wang
- Department of Scientific Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Jifa Hu
- Department of Scientific Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
- The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014 China
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6
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Wang F, Yu Y, Mubarik S, Zhang Y, Liu X, Cheng Y, Yu C, Cao J. Global Burden of Ischemic Heart Disease and Attributable Risk Factors, 1990-2017: A Secondary Analysis Based on the Global Burden of Disease Study 2017. Clin Epidemiol 2021; 13:859-870. [PMID: 34584461 PMCID: PMC8464307 DOI: 10.2147/clep.s317787] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/04/2021] [Indexed: 01/03/2023] Open
Abstract
Objective To estimate the burden of ischemic heart disease (IHD) stratified by gender, age, geographic location, and social-demographic status for 21 regions across the world from 1990 to 2017. Methods Using the Global Burden of Disease Study (GBD) Results Tool, we extracted data on the incidence, mortality, disability-adjusted life years (DALYs), and age-standardized rates related to IHD, as IHD burden measures. Trend analyzes were conducted for major regions. Risk factors for DALYs (obtained from the GBD comparative risk assessment framework) were also analyzed. Results Globally, 10.6 million (95% uncertainty interval [UI]: 9.6–11.8) cases of IHD occurred in 2017, with 8.9 million (95%UI:8.8–9.1) IHD-related deaths. Both the age-standardized incidence rate (ASIR) and death rate (ASDR) declined from 1990 to 2017 (percentage change: 27.4% and 30.0%, respectively), with average annual percent change (AAPC) values of −1.2% and −1.3%, respectively. In 2017, the global number of IHD-related DALYs was 170.3 million (95%UI:167.1–174.0), and the middle socio-demographic index (SDI) quintile contributed the most to these DALYs. In most regions, indicators (incidence, mortality, and DALYs) declined steadily with SDI increased. High systolic blood pressure (SBP) was the most significant contributor to the DALYs in most regions, accounting for 118.18 million DALYs in 2017 globally, followed by high low-density lipoprotein cholesterol and a diet low in nuts and seeds (101.78 and 52.86 million, respectively). Conclusion Even though the trend in IHD morbidity and mortality decreased globally, the IHD burden remains high, particularly in regions with lower SDI. It is necessary to learn successful and effective experience in controlling IHD risks and decreasing health disparities to reduce the IHD burden.
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Affiliation(s)
- Fang Wang
- Department of epidemiology and biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, People's Republic of China.,Department of biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China
| | - Yong Yu
- Computer Teaching and Research Section, School of Public Health, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
| | - Sumaira Mubarik
- Department of epidemiology and biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Yu Zhang
- Department of Public Health, Medical College, Hubei Polytechnic University, Huangshi, Hubei, People's Republic of China
| | - Xiaoxue Liu
- Department of epidemiology and biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Yao Cheng
- Obstetrics Department, Maternal and Child Health Care Hospital of Hubei Province, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Chuanhua Yu
- Department of epidemiology and biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, People's Republic of China.,Global Health Institute, Wuhan University, Wuhan, 430071, People's Republic of China
| | - Jinhong Cao
- Department of epidemiology and biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, People's Republic of China
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Vieira A, Ricoca VP, Aguiar P, Sousa P, Nunes C, Abrantes A. Years of life lost by COVID-19 in Portugal and comparison with other European countries in 2020. BMC Public Health 2021; 21:1054. [PMID: 34078348 PMCID: PMC8171993 DOI: 10.1186/s12889-021-11128-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of the COVID-19 pandemic has been measured in different metrics, mostly by counting deaths and its impact on health services. Few studies have attempted to calculate years of life lost (YLL) to COVID-19 and compare it with YLL due to other causes in different countries. METHODS We calculated YLL to COVID-19 from week10 to week52 in 2020 for eight European countries by methods defined by the WHO. We calculated excess YLL by subtracting the average YLL from 2017 to 2019 to the YLL in 2020. Our analysis compared YLL to COVID-19 and the excess YLL of non-COVID-19 causes across countries in Europe. RESULTS Portugal registered 394,573 cases and 6619 deaths due to COVID-19, accounting for 25,395 YLL in just 10 months. COVID-19 was responsible for 6.7% of all deaths but accounted for only 4.2% of all YLL. We estimate that Portugal experienced an excess of 35,510 YLL (+ 6.2%), of which 72% would have been due to COVID-19 and 28% due to non-COVID-19 causes. Spain, Portugal, and the Netherlands experienced excess YLL to non-COVID-19 causes. We also estimated that Portugal experienced an excess of 10,115 YLL due to cancer (3805), cardiovascular diseases (786) and diseases of the respiratory system (525). CONCLUSION COVID-19 has had a major impact on mortality rates in Portugal, as well as in other European countries. The relative impact of COVID-19 on the number of deaths has been greater than on the number of YLL, because COVID-19 deaths occur mostly in advanced ages.
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Affiliation(s)
- André Vieira
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal. .,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.
| | - Vasco Peixoto Ricoca
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
| | - Pedro Aguiar
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
| | - Paulo Sousa
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
| | - Carla Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
| | - Alexandre Abrantes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
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8
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Li PY, Chen RY, Wu FZ, Mar GY, Wu MT, Wang FW. Use of Coronary Computed Tomography Angiography to Screen Hospital Employees with Cardiovascular Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5462. [PMID: 34065262 PMCID: PMC8160889 DOI: 10.3390/ijerph18105462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022]
Abstract
The objective of this study was to determine how coronary computed tomography angiography (CCTA) can be employed to detect coronary artery disease in hospital employees, enabling early treatment and minimizing damage. All employees of our hospital were assessed using the Framingham Risk Score. Those with a 10-year risk of myocardial infarction or death of >10% were offered CCTA; the Coronary Artery Disease Reporting and Data System (CAD-RADS) score was the outcome. A total of 3923 hospital employees were included, and the number who had received CCTA was 309. Among these 309, 31 (10.0%) had a CAD-RADS score of 3-5, with 10 of the 31 (32.3%) requiring further cardiac catheterization; 161 (52.1%) had a score of 1-2; and 117 (37.9%) had a score of 0. In the multivariate logistic regression, only age of ≥ 55 years (p < 0.05), hypertension (p < 0.05), and hyperlipidemia (p < 0.05) were discovered to be significant risk factors for a CAD-RADS score of 3-5. Thus, regular and adequate control of chronic diseases is critical for patients, and more studies are required to be confirmed if there are more significant risk factors.
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Affiliation(s)
- Po-Yi Li
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (P.-Y.L.); (R.-Y.C.)
| | - Ru-Yih Chen
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (P.-Y.L.); (R.-Y.C.)
| | - Fu-Zong Wu
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (F.-Z.W.); (M.-T.W.)
| | - Guang-Yuan Mar
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan;
| | - Ming-Ting Wu
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (F.-Z.W.); (M.-T.W.)
| | - Fu-Wei Wang
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (P.-Y.L.); (R.-Y.C.)
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9
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Lui M, Safiri S, Mereke A, Davletov K, Mebonia N, Myrkassymova A, Aripov T, Mirrakhimov E, Aghayan SA, Gamkrelidze A, Naghavi M, Kopec JA, Sarrafzadegan N. Burden of Ischemic Heart Disease in Central Asian Countries, 1990-2017. IJC HEART & VASCULATURE 2021; 33:100726. [PMID: 33604451 PMCID: PMC7876559 DOI: 10.1016/j.ijcha.2021.100726] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/04/2021] [Accepted: 01/19/2021] [Indexed: 11/27/2022]
Abstract
Background The burden of ischemic heart disease (IHD) is high. There is limited information on the burden of IHD in identified high risk areas like Central Asia (CA) which is comprised of Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkmenistan, Mongolia, Uzbekistan and Tajikistan. This study addresses the burden of IHD in CA at the regional and country levels. Methods Using data from the latest iteration of the Global Burden of Disease Study (GBD), this study provides age-adjusted mortality, prevalence, and Disability Adjusted Life Years (DALYs) of IHD by sex in the CA region, and national levels for countries in this region from 1990 to 2017. Results The CA region has a higher IHD burden than the rest of the world over the studied period. Amongst the countries within this region, age-standardized mortality and DALY rates in Uzbekistan are the highest not only in CA but worldwide, while Armenia consistently has the lowest IHD burden in CA. Unhealthy diet, high systolic blood pressure and LDL-cholesterol are the risk factors with the highest attributable IHD DALYs. Conclusion Increasing burden of IHD over time in CA can be partially explained by the economic crisis in the 1990s. There is considerable variation in IHD DALY rates among countries in the CA region. The reasons for such differences are likely multifactorial such as differences in risk factors distribution, health care effectiveness, political, social and economic factors.
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Affiliation(s)
- Michelle Lui
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Saeid Safiri
- Tuberculosis and Lung Disease Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.,Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alibek Mereke
- Health Research Institute, The Faculty of Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Kairat Davletov
- Health Research Institute, The Faculty of Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Nana Mebonia
- Department of Epidemiology and Biostatistics, Tbilisi State Medical University, Tbilisi, Georgia
| | - Akbope Myrkassymova
- School of Public Health, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Timur Aripov
- Department of Public Health and Healthcare Management, Tashkent Institute of Postgraduate Medical Education, Tashkent, Uzbekistan
| | - Erkin Mirrakhimov
- Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.,National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
| | | | | | - Mohsen Naghavi
- Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, School of Medicine, University of Washington, Washington, USA
| | - Jacek A Kopec
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Nizal Sarrafzadegan
- School of Population & Public Health, University of British Columbia, Vancouver, Canada.,Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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10
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Ralapanawa U, Sivakanesan R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. J Epidemiol Glob Health 2021; 11:169-177. [PMID: 33605111 PMCID: PMC8242111 DOI: 10.2991/jegh.k.201217.001] [Citation(s) in RCA: 133] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 12/04/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Coronary Artery Disease (CAD) is the foremost single cause of mortality and loss of Disability Adjusted Life Years (DALYs) globally. A large percentage of this burden is found in low and middle income countries. This accounts for nearly 7 million deaths and 129 million DALYs annually and is a huge global economic burden. OBJECTIVE To review epidemiological data of coronary artery disease and acute coronary syndrome in low, middle and high income countries. METHODS Keyword searches of Medline, ISI, IBSS and Google Scholar databases. Manual search of other relevant journals and reference lists of primary articles. RESULTS Review of the results of studies reveals the absolute global and regional trends of the CAD and the importance and contribution of CAD for global health. Data demonstrates which region or countries have the highest and lowest age-standardized DALY rates and what factors might explain these patterns. Results also show differences among the determinants of CAD, government policies, clinical practice and public health measures across the various regions of world. CONCLUSION CAD mortality and prevalence vary among countries. Estimation of the true prevalence of CAD in the population is complex. A significant number of countries have not provided data, the estimation of the exact figures for epidemiological data is a barrier. The incidence of CAD continues to fall in developed countries over the last few decades and this may be due to both effective treatment of the acute phase and improved primary and secondary preventive measures. Developing countries show considerable variability in the incidence of CAD. The globalization of the Western diet and increased sedentary lifestyle will have a dramatic influence on the progressive increase in the incidence of CAD in these countries.
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Affiliation(s)
- U Ralapanawa
- Department of Medicine, University of Peradeniya, Sri Lanka
| | - R Sivakanesan
- Department of Biochemistry, University of Peradeniya, Sri Lanka
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11
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Multiscale classification of heart failure phenotypes by unsupervised clustering of unstructured electronic medical record data. Sci Rep 2020; 10:21340. [PMID: 33288774 PMCID: PMC7721729 DOI: 10.1038/s41598-020-77286-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
As a leading cause of death and morbidity, heart failure (HF) is responsible for a large portion of healthcare and disability costs worldwide. Current approaches to define specific HF subpopulations may fail to account for the diversity of etiologies, comorbidities, and factors driving disease progression, and therefore have limited value for clinical decision making and development of novel therapies. Here we present a novel and data-driven approach to understand and characterize the real-world manifestation of HF by clustering disease and symptom-related clinical concepts (complaints) captured from unstructured electronic health record clinical notes. We used natural language processing to construct vectorized representations of patient complaints followed by clustering to group HF patients by similarity of complaint vectors. We then identified complaints that were significantly enriched within each cluster using statistical testing. Breaking the HF population into groups of similar patients revealed a clinically interpretable hierarchy of subgroups characterized by similar HF manifestation. Importantly, our methodology revealed well-known etiologies, risk factors, and comorbid conditions of HF (including ischemic heart disease, aortic valve disease, atrial fibrillation, congenital heart disease, various cardiomyopathies, obesity, hypertension, diabetes, and chronic kidney disease) and yielded additional insights into the details of each HF subgroup's clinical manifestation of HF. Our approach is entirely hypothesis free and can therefore be readily applied for discovery of novel insights in alternative diseases or patient populations.
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12
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Niizeki T, Iwayama T, Kumagai Y, Ikeno E, Tsuchikane E. A case of right coronary artery chronic total occlusion with difficulty in retrograde system establishment. J Cardiol Cases 2020; 22:212-215. [PMID: 33133312 DOI: 10.1016/j.jccase.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/28/2020] [Accepted: 06/15/2020] [Indexed: 11/15/2022] Open
Abstract
Advances in microcatheters (MCs) enables the establishment of retrograde systems for the treatment of chronic total occlusion (CTO). However, there are still cases in which establishing a retrograde system is difficult because the guidewire or MC cannot pass through due to calcification, stenosis, or tortuosity. We present a case of a 56-year-old man with angina. Coronary angiography revealed a CTO of the right coronary artery (RCA). Although we started an antegrade approach at first, the guidewire went to subintimal lumen. We switched to a retrograde approach. Although the guidewire passed through posterolateral (PL) channel, the MC could not pass due to a stenosis at the junction of the main RCA trunk. Therefore, we negotiated the septal channel; however, it could only be guided in the peripheral direction. When the guidewire was more advanced in the peripheral direction, it crossed the guidewire that had previously passed through the PL channel. Then, when a balloon was delivered via the septal channel and trapped the guidewire from the PL channel, the MC was successfully delivered via the PL channel. After establishing the retrograde system, revascularization succeeded smoothly. In conclusion, this technique can be one option for the treatment of CTO patients. <Learning objective: Even if a guidewire passes retrogradely, the establishment of the retrograde system may be difficult in some cases since the microcatheter cannot pass retrogradely. This technique can be one of the effective options for the treatment of patients with chronic total occlusion when establishing a retrograde system is difficult.>.
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Affiliation(s)
- Takeshi Niizeki
- Department of Cardiology, Okitama Public General Hospital, Yamagata, Japan
| | - Tadateru Iwayama
- Department of Cardiology, Okitama Public General Hospital, Yamagata, Japan
| | - Yu Kumagai
- Department of Cardiology, Okitama Public General Hospital, Yamagata, Japan
| | - Eiichiro Ikeno
- Department of Cardiology, Okitama Public General Hospital, Yamagata, Japan
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13
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Spatial distribution of in- and out-of-hospital mortality one year after acute myocardial infarction in France. Am J Prev Cardiol 2020; 2:100037. [PMID: 34327460 PMCID: PMC8315588 DOI: 10.1016/j.ajpc.2020.100037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 11/21/2022] Open
Abstract
Objective To describe the spatial distribution of acute myocardial infarction (AMI) mortality in France in association with the socio-economic characteristics of the patient's place of residence. Methods In this population-based study, we included patients hospitalized for AMI identified according to ICD-10 codes, using data from the national health insurance database from January 1, 2013 to December 31, 2014. In- and out-of-hospital deaths were identified over a period of 1 year following the first hospital stay for AMI.An exploratory analysis was performed to classify area profiles. The spatial analysis of AMI mortality was performed using a principal component analysis followed by an ascending hierarchical classification taking into account socio-economic data, access-time by road to coronary angiography, standardized in-hospital prevalence, and 1 year mortality. Results Over the 2 years, 115,418 patients were hospitalized with a diagnosis of AMI. Patients were a mean of 68 ± 15 years and most were men (68.5%). The overall mortality rate was 12.2% after 1 year. More than half of patients (65.5%) underwent an early revascularization procedure. The map of standardized 1 year mortality showed a geographic area of high mortality extending diagonally from north-east to south-west France. We identified 6 different area profiles with standardized mortality varying from 15.9 to 54.4 per 100,000 inhabitants. The spatial distribution of higher mortality was associated with lower socioeconomic levels. These findings were not associated with a lower access to coronary angiography. Conclusion There are considerable geographical differences in the prevalence of AMI and 1 year mortality. The spatial distribution of lower healthcare indicators follows the distribution of social inequalities. This study highlights the importance of focusing national policies on universally accessible prevention programs such as the promotion cardiac rehabilitation and healthy lifestyles.
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14
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Movsisyan NK, Vinciguerra M, Medina-Inojosa JR, Lopez-Jimenez F. Cardiovascular Diseases in Central and Eastern Europe: A Call for More Surveillance and Evidence-Based Health Promotion. Ann Glob Health 2020; 86:21. [PMID: 32166066 PMCID: PMC7059421 DOI: 10.5334/aogh.2713] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objectives The paper aims to identify the priorities for cardiovascular health promotion research in Central and Eastern Europe (CEE), the region with the highest cardiovascular diseases (CVD) burden in the world. Methods This narrative review covered peer-reviewed publications and online databases using a nonsystematic purposive approach. Results In despite of a steady decrease in CVD burden in the region, the East-West disparities are still significant. There is minimal continuity in the past and current CVD prevention efforts in the region. Many challenges still exist, including an opportunity gap in research funding, surveillance and population-based preventive interventions. A comprehensive approach focusing on multisectoral cooperation, quality and accessibility of healthcare and equity-oriented public policies and supported by well-designed epidemiologic studies is needed to overcome these challenges. Conclusion The current level of effort is not adequate to address the magnitude of the CVD epidemic in CEE. It is imperative to strengthen the epidemiological base concerning cardiovascular health in the region, to foster surveillance and progress in implementation of CVD preventive strategies in the most affected populations of Europe.
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Affiliation(s)
- Narine K. Movsisyan
- International Clinical Research Center, St. Anne’s University Hospital, Brno, CR
| | - Manlio Vinciguerra
- International Clinical Research Center, St. Anne’s University Hospital, Brno, CR
| | - Jose R. Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, US
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, US
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15
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Fan WG, Xie F, Wan YR, Campbell NRC, Su H. The impact of changes in population blood pressure on hypertension prevalence and control in China. J Clin Hypertens (Greenwich) 2020; 22:150-156. [PMID: 32003937 DOI: 10.1111/jch.13820] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/27/2019] [Accepted: 12/10/2019] [Indexed: 01/20/2023]
Abstract
In China, there are approximately 250 million adults who have hypertension with low rates of awareness, treatment and control. Changes in lifestyles at a population level have the potential to enhance or deteriorate the prevention and control of hypertension. We used data from a regional hypertension survey to examine the impact of 2/1 mm Hg decreases or increases in population blood pressure on hypertension prevalence, and rates of unawareness of the hypertension diagnosis, treatment, and control. The primary analysis was based on the average blood pressure of respondents from three visits and a diagnostic threshold of 140/90 mm Hg for hypertension. Secondary analyses examined average blood pressure from the first survey visit and also a diagnostic threshold of 130/80 mm Hg for hypertension. The baseline hypertension prevalence was 33.4%, and rates of unawareness of the hypertension diagnosis, treatment, and control were 74.2%, 25.8%, and 9.7%, respectively. Decreases or increases in blood pressure by 10/5 mm Hg resulted in changes in hypertension prevalence (22.1% vs 53.4%) and rates of unawareness of the diagnosis (60.9% vs 83.8%), treatment (39.1% vs 16.2%), and control (21.2% vs 3.6%), respectively. Similar trends were seen in the secondary analyses. Population changes in lifestyle could have a very large impact on the prevalence and control of hypertension in China. The results support implementation of programs to improve population lifestyles while implementing health services policies to enhance the clinical management of hypertension.
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Affiliation(s)
- Wei-Guo Fan
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Xie
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi-Rong Wan
- Dutou Hospital of Nanchang County, Jiangxi, China
| | - Norm R C Campbell
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Hai Su
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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16
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Reuven Y, Shvartzman P, Dreiher J. Cardiovascular Disease and hospital admissions in African immigrants and former Soviet Union immigrants: A retrospective cohort study. Int J Cardiol 2019; 296:172-176. [PMID: 31477314 DOI: 10.1016/j.ijcard.2019.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 07/02/2019] [Accepted: 08/07/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous studies reported low prevalence of cardiovascular disease (CVD) despite an increasing prevalence of metabolic abnormalities in immigrants who moved from low CVD-risk regions to Western countries. Nevertheless, little is known about hospital admissions due to CVD in immigrants. METHODS A retrospective cohort study of East Africa immigrants (EAI), Former Soviet Union immigrants (FSUI) and native-born Israelis (NBI) over 11-year period. Associations between ethnicity, age, sex, CVD, and hospital admission were assessed using logistic and Poisson regression models. Incidence density rates per person-years were calculated. RESULTS The age-adjusted prevalence rates of ischemic heart disease in EAI, FSUI and NBI, respectively, were 1.8%, 8.2%, and 5.8%, respectively (p < 0.001). The corresponding rates for stroke were 2.6%, 3.5%, and 2.5%, respectively. Multivariate odds ratios for all CVD were found to be significantly lower in EAI for both sexes. Hospitalizations rate due to CVD were 9, 17, and 6 per 1000 person-years in EAI, FSUI and NBI, respectively (p < 0.001). EAI were more likely to be hospitalized due to hypertensive disease, cerebral vascular diseases and heart disease, in comparison to NBI and FSUI. However, when controlling for CVD risk factors profile, EAI had similar admission rates to NBI. EAI were more likely to be hospitalized in internal medicine, geriatrics, and neurology departments, and less likely to be admitted to intensive care units or surgical department. CONCLUSIONS EAI had low rates of all types of CVD, and low risk of hospitalization after controlling for CVD risk factors profile.
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Affiliation(s)
- Yonatan Reuven
- Department of Family Medicine and Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | - Pesach Shvartzman
- Department of Family Medicine and Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel; Southern District, Clalit Health Services, Israel
| | - Jacob Dreiher
- Department of Family Medicine and Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel; Soroka University Medical Center, Beer Sheva, Israel
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17
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Advances in Hemodynamic Analysis in Cardiovascular Diseases Investigation of Energetic Characteristics of Adult and Pediatric Sputnik Left Ventricular Assist Devices during Mock Circulation Support. Cardiol Res Pract 2019; 2019:4593174. [PMID: 31885902 PMCID: PMC6925692 DOI: 10.1155/2019/4593174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/11/2019] [Accepted: 10/17/2019] [Indexed: 11/17/2022] Open
Abstract
The need to simulate the operating conditions of the human body is a key factor in every study and engineering process of a bioengineering device developed for implantation. In the present paper, we describe in detail the interaction between the left ventricle (LV) and our Sputnik left ventricular assist devices (LVADs). This research aims to evaluate the influence of different rotary blood pumps (RBPs) on the LV depending on the degree of heart failure (HF), in order to investigate energetic characteristics of the LV-LVAD interaction and to estimate main parameters of left ventricular unloading. We investigate energetic characteristics of adult Sputnik 1 and Sputnik 2 LVADs connected to a hybrid adult mock circulation (HAMC) and also for the Sputnik pediatric rotary blood pump (PRBP) connected to a pediatric mock circulation (PMC). A major improvement of the LV unloading is observed during all simulations for each particular heart failure state when connected to the LVAD, with sequential pump speed increased within 5000–10000 rpm for adult LVADs and 6000–13000 rpm for PRBP with 200 rpm step. Additionally, it was found that depending on the degree of heart failure, LVADs influence the LV in different ways and a significant support level cannot be achieved without the aortic valve closure. Furthermore, this study expands the information on LV-LVAD interaction, which leads to the optimization of the RBP speed rate control in clinics for adult and pediatric patients suffering from heart failure. Finally, we show that the implementation of control algorithms using the modulation of the RBP speed in order to open the aortic valve and unload the LV more efficiently is necessary and will be content of further research.
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18
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Abstract
Background Ischemic heart disease (IHD) has been considered the top cause of mortality globally. However, countries differ in their rates and there have been changes over time. Methods and Results We analyzed mortality data submitted to the World Health Organization from 2005 to 2015 by individual countries. We explored patterns in relationships with age, sex, and income and calculated age-standardized mortality rates for each country in addition to crude death rates. In 5 illustrative countries which provided detailed data, we analyzed trends of mortality from IHD and 3 noncommunicable diseases (lung cancer, stroke, and chronic lower respiratory tract diseases) and examined the simultaneous trends in important cardiovascular risk factors. Russia, United States, and Ukraine had the largest absolute numbers of deaths among the countries that provided data. Among 5 illustrative countries (United Kingdom, United States, Brazil, Kazakhstan, and Ukraine), IHD was the top cause of death, but mortality from IHD has progressively decreased from 2005 to 2015. Age-standardized IHD mortality rates per 100 000 people per year were much higher in Ukraine (324) and Kazakhstan (97) than in United States (60), Brazil (54), and the United Kingdom (46), with much less difference in other causes of death. All 5 countries showed a progressive decline in IHD mortality, with a decline in smoking and hypertension and in all cases a rise in obesity and type II diabetes mellitus. Conclusions IHD remains the single largest cause of death in countries of all income groups. Rates are different between countries and are falling in most countries, indicating great potential for further gains. On the horizon, future improvements may become curtailed by increasing hypertension in some developing countries and more importantly global growth in obesity.
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Affiliation(s)
- Alexandra N Nowbar
- International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom (A.N.N., M.G., J.P.H., D.P.F., R.A.-L.)
| | - Mauro Gitto
- International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom (A.N.N., M.G., J.P.H., D.P.F., R.A.-L.).,Interventional Cardiology Division, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy (M.G.)
| | - James P Howard
- International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom (A.N.N., M.G., J.P.H., D.P.F., R.A.-L.)
| | - Darrel P Francis
- International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom (A.N.N., M.G., J.P.H., D.P.F., R.A.-L.)
| | - Rasha Al-Lamee
- International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom (A.N.N., M.G., J.P.H., D.P.F., R.A.-L.)
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