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Højstrup S, Thomsen JH, Prescott E. Disparities in cardiovascular disease and treatment in the Nordic countries. THE LANCET REGIONAL HEALTH. EUROPE 2023; 33:100699. [PMID: 37953994 PMCID: PMC10636266 DOI: 10.1016/j.lanepe.2023.100699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 11/14/2023]
Abstract
The Nordic countries, including Denmark, Finland, Iceland, Norway, and Sweden have seen a steep decline in cardiovascular mortality in recent decades. They are among the most egalitarian countries by several measures, and all have universal, publicly funded welfare systems providing healthcare for all citizens. However, despite these seemingly ideal conditions, disparities in access to cardiovascular care and outcomes persist. To address this challenge, The Lancet Region Health-Europe convened experts from a broad range of countries to summarize the current state of knowledge on cardiovascular disease disparities across Europe. This Series Paper presents the main challenges in Nordic countries based on evidence from high-quality nationwide registries. Focusing on major cardiovascular health determinants, areas in need of improvement were identified. There is a need for addressing structural causes underlying these disparities, such as poverty and discrimination, but also to improve access to healthcare in deprived neighborhoods and to address underlying social determinants of health that may mitigate disparities in cardiovascular outcomes. Overall, while the Nordic countries have made great strides in promoting egalitarianism and providing universal healthcare, there is still much work to be done to ensure equitable access to care and improved cardiovascular outcomes for all members of society.
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Affiliation(s)
- Signe Højstrup
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jakob Hartvig Thomsen
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Eva Prescott
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Zhu L, Huang BT, Chen M. The mortality risk after myocardial infraction in migrants compared with natives: a systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1101386. [PMID: 37293275 PMCID: PMC10244764 DOI: 10.3389/fcvm.2023.1101386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/17/2023] [Indexed: 06/10/2023] Open
Abstract
Background and Objective The evidence on the risk of mortality after myocardial infarction (MI) among migrants compared with natives is mixed and limited. The aim of this study is to assess the mortality risk after MI in migrants compared to natives. Methods This study protocol is registered with PROSPERO, number CRD42022350876. We searched the Medline and Embase databases, without time and language constraints, for cohort studies that reported the risk of mortality after MI in migrants compared to natives. The migration status is confirmed by country of birth, both migrants and natives are general terms and are not restricted to a particular country or area of destination or origin. Two reviewers separately screened searched studies according to selection criteria, extracted data, and assessed data quality using the Newcastle-Ottawa Scale (NOS) and risk of bias of included studies. Pooled estimates of adjusted and unadjusted mortality after MI were calculated separately using a random-effects model, and subgroup analysis was performed by region of origin and follow-up time. Result A total of 6 studies were enrolled, including 34,835 migrants and 284,629 natives. The pooled adjusted all-cause mortality of migrants after MI was higher than that of natives (OR, 1.24; 95% CI, 1.10-1.39; I2 = 83.1%), while the the pooled unadjusted mortality of migrants after MI was not significantly different from that of natives (OR, 1.11; 95% CI, 0.69-1.79; I2 = 99.3%). In subgroup analyses, adjusted 5-10 years mortality (3 studies) was higher in the migrant population (OR, 1.27; 95% CI, 1.12-1.45; I2 = 86.8%), while adjusted 30 days (4 studies) and 1-3 years (3 studies) mortality were not significantly different between the two groups. Migrants from Europe (4 studies) (OR, 1.34; 95% CI, 1.16-1.55; I2 = 39%), Africa (3 studies) (OR, 1.50; 95% CI, 01.31-1.72; I2 = 0%), and Latin America (2 studies) (OR, 1.44; 95% CI, 1.30-1.60; I2 = 0%) had significantly higher rates of post-MI mortality than natives, with the exception of migrants of Asian origin (4 studies) (OR, 1.20; 95% CI, 0.99-1.46; I2 = 72.7%). Conclusions Migrants tend to have lower socioeconomic status, greater psychological stress, less social support, limited access to health care resources, etc., therefore, face a higher risk of mortality after MI in the long term compared to natives. Further research is needed to confirm our conclusions, and more attention should be paid to the cardiovascular health of migrants. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier: r CRD42022350876.
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Affiliation(s)
| | | | - Mao Chen
- Correspondence: Bao-tao Huang Mao Chen
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Sia CH, Ko J, Zheng H, Ho AFW, Foo D, Foo LL, Lim PZY, Liew BW, Chai P, Yeo TC, Yip JWL, Chua T, Chan MYY, Tan JWC, Figtree G, Bulluck H, Hausenloy DJ. Comparison of Mortality Outcomes in Acute Myocardial Infarction Patients With or Without Standard Modifiable Cardiovascular Risk Factors. Front Cardiovasc Med 2022; 9:876465. [PMID: 35497977 PMCID: PMC9047915 DOI: 10.3389/fcvm.2022.876465] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Acute myocardial infarction (AMI) cases have decreased in part due to the advent of targeted therapies for standard modifiable cardiovascular disease risk factors (SMuRF). Recent studies have reported that ST-elevation myocardial infarction (STEMI) patients without SMuRF (termed “SMuRF-less”) may be increasing in prevalence and have worse outcomes than “SMuRF-positive” patients. As these studies have been limited to STEMI and comprised mainly Caucasian cohorts, we investigated the changes in the prevalence and mortality of both SMuRF-less STEMI and non-STEMI (NSTEMI) patients in a multiethnic Asian population. Methods We evaluated 23,922 STEMI and 62,631 NSTEMI patients from a national multiethnic registry. Short-term cardiovascular and all-cause mortalities in SMuRF-less patients were compared to SMuRF-positive patients. Results The proportions of SMuRF-less STEMI but not of NSTEMI have increased over the years. In hospitals, all-cause and cardiovascular mortality and 1-year cardiovascular mortality were significantly higher in SMuRF-less STEMI after adjustment for age, creatinine, and hemoglobin. However, this difference did not remain after adjusting for anterior infarction, cardiopulmonary resuscitation (CPR), and Killip class. There were no differences in mortality in SMuRF-less NSTEMI. In contrast to Chinese and Malay patients, SMuRF-less patients of South Asian descent had a two-fold higher risk of in-hospital all-cause mortality even after adjusting for features of increased disease severity. Conclusion SMuRF-less patients had an increased risk of mortality with STEMI, suggesting that there may be unidentified nonstandard risk factors predisposing SMuRF-less patients to a worse prognosis. This group of patients may benefit from more intensive secondary prevention strategies to improve clinical outcomes.
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Affiliation(s)
- Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Junsuk Ko
- MD Program, Duke-NUS Medical School, Singapore, Singapore
| | - Huili Zheng
- Health Promotion Board, National Registry of Diseases Office, Singapore, Singapore
| | - Andrew Fu-Wah Ho
- SingHealth Duke-NUS Emergency Medicine Academic Clinical Programme, Singapore, Singapore
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Pre-hospital and Emergency Care Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - David Foo
- Tan Tock Seng Hospital, Singapore, Singapore
| | - Ling-Li Foo
- Health Promotion Board, National Registry of Diseases Office, Singapore, Singapore
| | | | | | - Ping Chai
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tiong-Cheng Yeo
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - James W. L. Yip
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Terrance Chua
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore
| | - Mark Yan-Yee Chan
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jack Wei Chieh Tan
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore
| | - Gemma Figtree
- Sydney Medical School (Northern), University of Sydney, Sydney, NSW, Australia
| | | | - Derek J. Hausenloy
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore, Singapore
- The Hatter Cardiovascular Institute, University College London, London, United Kingdom
- Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taichung City, Taiwan
- *Correspondence: Derek J. Hausenloy
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Rye E, Lee A, Mukhtar H, Narayan A, Robert Denniss A, Chow C, Kovoor P, Sivagangabalan G. ST-elevation myocardial infarction in a migrant population: a registry-based study of patient treatment and outcomes. Intern Med J 2019; 49:502-512. [PMID: 30152033 DOI: 10.1111/imj.14084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/20/2018] [Accepted: 08/22/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Internationally, a growing number of studies has identified race-related disparities in the presentation, treatment and outcomes of patients with ST-elevation myocardial infarction (STEMI). With a large migrant population, Australia presents a unique microcosm in which to study the impact of migrant status and ethnicity in STEMI patients. AIM To investigate if first-generation migrants differed in presentation, treatment or outcomes following STEMI compared with the Australian-born population. METHODS We conducted a retrospective observational study using data from a clinician-initiated registry. The study involved 2154 patients who presented to 12 hospitals between 2004 and 2012. Our main outcome measures included time to reperfusion, 30-day mortality and complications. RESULTS Migrants (n = 1035, 48.8%) were more likely to be older (61 vs 58 years, P < 0.001), diabetic (29.3 vs 21.5%, P < 0.001) and have a prolonged symptom to door time (102 vs 91 min, P = 0.04). Despite lower rates of previous known ischaemic heart disease (22.5 vs 26.6%, P = 0.03), migrants had more diffuse disease (triple vessel or left main (3VD/LM): 29.8 vs 22.0%, P < 0.001) and higher troponin values (3.77 vs 3.22 μg/L, P = 0.01). We found no significant differences in hospital treatment times, intervention types or rates. Multivariate regression identified age, diabetes, female gender and multi-vessel disease as predictors of complications and death at 30 days. CONCLUSIONS Migrants had longer pre-hospital delays and exhibited different cardiovascular risk profiles than Australian-born patients but received comparable treatment in the acute hospital setting. Higher rates of diabetes and multi-vessel coronary artery disease were seen among migrant patients, indicating a relatively higher risk population.
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Affiliation(s)
- Eleanor Rye
- School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Andrea Lee
- School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Hadia Mukhtar
- School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Arun Narayan
- Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia
| | - A Robert Denniss
- Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Clara Chow
- Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Pramesh Kovoor
- Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Gopal Sivagangabalan
- School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia.,Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia
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Shvartsur R, Shiyovich A, Gilutz H, Azab AN, Plakht Y. Short and long-term prognosis following acute myocardial infarction according to the country of origin. Soroka acute myocardial infarction II (SAMI II) project. Int J Cardiol 2018; 259:227-233. [PMID: 29499852 DOI: 10.1016/j.ijcard.2018.02.079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/11/2018] [Accepted: 02/20/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Reports from many countries have shown birthplace-associated disparities in the incidence and mortality following acute myocardial infarction (AMI). The aims of the study were to identify and compare short- and long-term post-AMI mortality according to birthplace. METHODS A retrospective analysis of Israeli AMI patients from a tertiary medical center in Southern Israel throughout 2002-2012. DATA SOURCE the hospital's computerized systems. Patients were classified according to the country of birth (Israel, Southern Europe/Balkans, Northern Africa, Eastern/Central Europe, India/Pakistan, Middle-East, Yemen, and Ethiopia). STUDY OUTCOMES in-hospital and up to 10-years post-discharge all-cause mortality. RESULTS The study included 11,143 patients, age 67.4 ± 13.9 and 67.5% men. Israeli-born patients were significantly younger, with lower rate of diabetes mellitus and hypertension but significantly higher rate of obesity, smoking, history of coronary artery disease and male sex compared with immigrants. The rate of STEMI and administration of percutaneous coronary revascularization was higher, yet extent of coronary findings and severe left ventricular dysfunction was lower in Israeli-born patients. In-hospital as well as post-discharge 1-and 10-year mortality rates were approximately 65% lower in Israeli-born patients compared with immigrants. Following adjustment for potential confounders the inequalities in post-discharge mortality attenuated (Yemen OR = 2.3 [95%CI: 1.4-3.6], Southern Europe/Balkans 1.75 [1.2-2.5], Northern Africa 1.5 [1.3-1.8], Eastern/Central Europe 1.4 [1.2-1.7] and India/Pakistan 1.4 [1.1-1.9], for 10-years mortality, p < 0.05 for each) and those for in-hospital mortality disappeared. CONCLUSIONS Immigrants are at increased risk for post-discharge, yet not in-hospital mortality following AMI. Appropriate targeted preventive programs are required for these groups of patients.
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Affiliation(s)
- Rachel Shvartsur
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Arthur Shiyovich
- Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Harel Gilutz
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Beer-Sheva, Israel
| | - Abed N Azab
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Beer-Sheva, Israel
| | - Ygal Plakht
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Beer-Sheva, Israel.
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Wechkunanukul K, Grantham H, Teubner D, Hyun KK, Clark RA. Presenting characteristics and processing times for culturally and linguistically diverse (CALD) patients with chest pain in an emergency department: Time, Ethnicity, and Delay (TED) Study II. Int J Cardiol 2016; 220:901-8. [PMID: 27404505 DOI: 10.1016/j.ijcard.2016.06.244] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/26/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND To date there has been limited published data presenting the characteristics and timeliness of the management in an Emergency Department (ED) for culturally and linguistically diverse (CALD) patients presenting with chest pain. This study aimed to describe the presenting characteristics and processing times for CALD patients with chest pain compared to the Australian-born population, and current guidelines. METHODS This study was a cross sectional analysis of a cohort of patients who presented with chest pain to the metropolitan hospital between 1 July 2012 and 30 June 2014. RESULTS Of the total study population (n=6640), 1241 (18.7%) were CALD and 5399 (81.3%) were Australian-born. CALD patients were significantly older than Australian-born patients (mean age 62 vs 56years, p<0.001). There were no differences in the proportion of patients who had central chest pain (74.9% vs 75.7%, p=0.526); ambulance utilisation (41.7% vs 41.1%, p=0.697); and time to initial treatment in ED (21 vs 22min, p=0.375). However, CALD patients spent a significantly longer total time in ED (5.4 vs 4.3h, p<0.001). There was no difference in guideline concordance between the two groups with low rates of 12.5% vs 13%, p=0.556. Nonetheless, CALD patients were 22% (95% CI, 0.65, 0.95, p=0.015) less likely to receive the guideline management for chest pain. CONCLUSIONS The initial emergency care was equally provided to all patients in the context of a low rate of concordance with three chest pain related standards from the two guidelines. Nonetheless, CALD patients spent a longer time in ED compared to the Australian-born group.
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Affiliation(s)
- Kannikar Wechkunanukul
- School of Nursing and Midwifery, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia.
| | - Hugh Grantham
- Paramedic Department, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia.
| | - David Teubner
- Paramedic Department, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia.
| | - Karice K Hyun
- The George Institute for Global Health, Cardiovascular division, Sydney Medical School, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, Camperdown, NSW 2050, Australia.
| | - Robyn A Clark
- School of Nursing and Midwifery, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia.
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Bradshaw PJ, Katzenellenbogen JM, Sanfilippo FM, Hobbs MST, Thompson PL, Thompson SC. Validation study of GRACE risk scores in indigenous and non-indigenous patients hospitalized with acute coronary syndrome. BMC Cardiovasc Disord 2015; 15:151. [PMID: 26573571 PMCID: PMC4647306 DOI: 10.1186/s12872-015-0138-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 10/30/2015] [Indexed: 12/22/2022] Open
Abstract
Background Although cardiovascular disease is the major cause of premature death among Indigenous peoples in several advanced economies, no acute coronary syndrome (ACS) risk models have been validated in Indigenous populations. We tested the validity and calibration of three Global Registry of Acute Coronary Events (GRACE) scores among Aboriginal and non-Aboriginal Australians. Methods GRACE scores were calculated at admission or discharge using clinical data, with all-cause deaths obtained from data linkage. Scores for GRACE models were validated for; 1) in-hospital death, 2) death within 6 months from admission or 3) death within 6 months of discharge (this also for 1 and 5-years mortality). Results Aboriginal patient were younger (62 % aged <55 years versus 15 % non-Aboriginal) and their median GRACE scores lower than non-Aboriginal patients, as was crude mortality at 6 months from admission (6 % vs 10 %) and at 1 and 5 years. After age stratification, risk scores for Aboriginal patients were equivalent or higher, especially among those aged <55 years. There was a trend to more deaths after discharge among Aboriginal patients in each age group, suggesting an age-related under-estimation of risk. The c-statistics for the three GRACE models within both groups were between 0.75 and 0.79. Conclusions We demonstrated for the first time that while the discriminatory capacity of GRACE risk scores among Indigenous Australians is good, the models may need re-calibrating to improve risk stratification in this and other Indigenous groups, where age of onset of coronary disease is much younger than among the original reference population.
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Affiliation(s)
- Pamela J Bradshaw
- School of Population Health, University of Western Australia, M431, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,Western Australian Centre for Rural Health, University of Western Australia, M706, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Judith M Katzenellenbogen
- Western Australian Centre for Rural Health, University of Western Australia, M706, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Frank M Sanfilippo
- School of Population Health, University of Western Australia, M431, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Michael S T Hobbs
- School of Population Health, University of Western Australia, M431, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Peter L Thompson
- School of Population Health, University of Western Australia, M431, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,Department of Research, 2nd Floor A Block (Mailbox 26), Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, 6009, WA, Australia.
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia, M706, 35 Stirling Highway, Crawley, WA, 6009, Australia.
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Odili AN, Ogedengbe JO, Nwegbu M, Anumah FO, Asala S, Staessen JA. Nigerian Population Research on Environment, Gene and Health (NIPREGH) - objectives and protocol. J Biomed Res 2014; 28:360-7. [PMID: 25332707 PMCID: PMC4197386 DOI: 10.7555/jbr.28.20130199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 03/11/2014] [Accepted: 05/07/2014] [Indexed: 11/21/2022] Open
Abstract
Sub-Saharan Africa is currently undergoing an epidemiological transition from a disease burden largely attributable to communicable diseases to that resulting from a combination of both communicable and chronic non-communicable diseases. Data on chronic disease incidence, lifestyle, environmental and genetic risk factors are sparse in this region. This report aimed at providing relevant information in respect to risk factors that increase blood pressure and lead to development of intermediate cardiovascular phenotypes. We presented the rationale, objectives and key methodological features of the Nigerian Population Research on Environment, Gene and Health (NIPREGH) study. The challenges encountered in carrying out population study in this part of the world and the approaches at surmounting them were also presented. The preliminary data as at 20 November 2013 showed that out of the 205 individuals invited starting from early April 2013, 160 (72 women) consented and were enrolled; giving a response rate of 78%. Participants' age ranged from 18 to 80 years, with a mean (SD) of 39.8 (12.4) years and they were of 34 different ethnic groups spread over 24 states out of the 36 states that constitute Nigeria. The mean (SD) of office and home blood pressures were 113.0 (15.2) mm Hg systolic, 73.5 (12.5) mm Hg diastolic and 117.3 (15.0) mm Hg systolic, and 76.0 (9.6) mm Hg diastolic, respectively. Forty-three (26.8%) participants were hypertensive and 8 (5.0%) were diabetic. In addition to having the unique potential of recruiting a cohort that is a true representative of the entire Nigerian population, NIPREGH is feasible and the objectives realisable.
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Affiliation(s)
- Augustine N Odili
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria. ; Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - John O Ogedengbe
- Department of Human Physiology, Faculty of Basic Medical Science, Chemical Pathology, Faculty of Basic Clinical, Anatomical Sciences, Faculty of Basic Medical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Maxwell Nwegbu
- Department of Human Physiology, Faculty of Basic Medical Science, Chemical Pathology, Faculty of Basic Clinical, Anatomical Sciences, Faculty of Basic Medical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Felicia O Anumah
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Samuel Asala
- Department of Human Physiology, Faculty of Basic Medical Science, Chemical Pathology, Faculty of Basic Clinical, Anatomical Sciences, Faculty of Basic Medical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Jan A Staessen
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium. ; Department of Epidemiology, University of Maastricht, Maastricht, The Netherlands. ; Department of Epidemiology, University of Maastricht, Maastricht, The Netherlands
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