Cvd Prevention and Control最新文献

Background and objectives

There is little knowledge on whether clustering of hyperlipidemia, hyperglycemia, alcohol drinking, overweight and central obesity increases risk of hypertension in Mongolian people of rural and animal husbandry area.

Methods

A cross sectional study was performed in a Mongolian population. Demographic data, lifestyle factors, family history of hypertension, blood pressure measurements, physical examination were obtained and blood glucose and lipids were examined in 2532 individuals.

Results

Hyperlipidemia, hyperglycemia, alcohol drinking, overweight and central obesity were all independently associated with hypertension (all P < 0.01), and clustering of these risk factors correlated with risk of hypertension in Mongolian people. Age and gender-adjusted OR of hypertension for clustering of two, three and four or more factors were 1.878(1.262, 2.795), 3.735(2.529, 5.516) and 4.361(2.886, 6.589), respectively.

Conclusions

Hyperlipidemia, hyperglycemia, alcohol drinking, overweight and central obesity were independent risk factors of hypertension. Risk of hypertension in Mongolian people increased with the number of up to five risk factors in clusters. It is imperative that risk factors be controlled at the same time for the primary prevention and early treatment of hypertension.

Hepatitis C virus (HCV) is the cause of many different forms of heart disease worldwide, and yet few cardiologists are aware of it as an etiology of heart disease, or its treatment. The burden of HCV-derived heart diseases is global, with a higher prevalence in Asia, Africa, and low- and middle-income countries. Our study showed that in more than 10% of Japanese patients, their cardiomyopathies are associated with HCV infection. More recently, we found in the USA that up to 15% of patients with heart failure with myocarditis have associated HCV infection. In contrast, in China 79% of patients with hepatocellular cancer and 37% of hepatitis C patients have heart disease, as detected by measuring a proven and sensitive biomarker of heart disease, NT-proBNP. In Pakistan, 17% of hepatitis C patients have heart diseases, as measured by this metric.

Based on these data, 3% of 6.6 billion (198 million) persons worldwide are infected with HCV, and 17–37% (34–73 million) persons are suffering from HCV-derived heart diseases. These figures may be comparable to the number of patients with hepatitis C. HCV infection causes only hepatitis in some patients, only heart diseases in some patients, and both hepatitis and heart diseases in other patients.

A global network is required to establish methods to detect heart diseases caused by infectious agents. Other goals for the network are the expansion of preventive and therapeutic programs in underprivileged countries.

Background

Despite the overwhelming evidence from clinical trials showing that preventive measures recommended by recent guidelines significantly reduce mortality, the implementation rate in patients with high cardiovascular risk is still far from optimal.

Methods

A total of 5600 patients with a high cardiovascular risk were invited to participate however 3331 (59%) agreed to a five year follow-up in a multicenter, observational study. Primary end-points included death, myocardial infarction, stroke and optimal medication use over 5 years.

Results

Primary end-points including cardiovascular mortality were higher in patients with vascular disease (25.3% vs 15.1%, p < 0.001, and 13.5 vs 6.2%, p < 0.001, respectively) and it was doubled in 5 years. Presence of end organ damage further increased the incidence of primary end-point and cardiovascular mortality (30.6% vs 16.2%, p < 0.001 and 18.1% vs 6.8%, p < 0.001, respectively). The optimal preventive treatment (statin, renin-angiotensin system blocker, beta-blocker and antiplatelet) rate was low and did not change significantly in 5 years, although the consistent use of angiotensin-converting enzyme inhibitor seemed to be a protective predictor of cardiovascular mortality.

Conclusion

In this high risk Turkish population, mortality and morbidity in the medium to long term were high and the implementation rate of optimal preventive treatment unacceptably low. The highest risk subgroup was identified to be those with previous vascular disease/event and end organ damage requiring aggressive medical treatment.

Background

Hypertension has emerged as a major public health problem in developing countries. Despite an increasing prevalence of hypertension in India, people’s knowledge and perceptions, which are vital during interventions to bring behavioural change, are not known widely.

Methods

Data pertaining to blood pressure, height, weight; socio-demographic details and knowledge and perceptions on hypertension were obtained from a total of 453 individuals (227 neo-migrants and 226 settled-migrants) aged 20 years and above.

Results

Around 62% of respondents had heard of blood pressure. This awareness was comparatively more among women and settled-migrants. Less than half of the respondents considered hypertension a serious condition, and a considerable proportion did not perceive that hypertension leads to other diseases. With regard to prevention and control, more than one third suggested lessening tension and anger followed by reducing salt intake/dietary changes, and a very small proportion mentioned that exercise would help. Regarding treatment, three fourths of the respondents considered that hypertension can be treated, mostly by medicines and only 10% considered lifestyle changes along with medicines. Thus, in these communities, more than a half possessed the knowledge, less than a half perceived that hypertension can be prevented, and less than a half of these followed at least one of the lifestyle changes mentioned by them.

Conclusion

Despite the higher prevalence of hypertension, knowledge about hypertension was only moderate and comprehensive knowledge was lacking, with the ‘rule of halves’ still valid in these migrant populations. The study underscores the importance of increasing public health knowledge and awareness in preventing and controlling hypertension along with the provision of primary health care services with an emphasis on hypertension and related cardiovascular diseases for these socio-economically disadvantaged communities.

Coronary artery disease (CAD) is by far the commonest cause of sudden cardiac death (SCD), with the prevalence of CAD paralleling the incidence of SCD in epidemiological studies. With the alarming increase in prevalence of CAD, diabetes and hypertension in India, the incidence of SCD is also on the rise, especially in the urban regions. While the mortality of CAD in the West has decreased, it has reached epidemic proportions in India. Consequently, there is a need for implementing preventive cardiovascular health measures to meaningfully reduce the incidence of SCD.

Background

In Kyrgyz Republic, some, but not all, workplaces and public places have been designated smoke-free, but the extent of support for this is unknown. The aim of this study was to determine how big if any this support is.

Methods

A cross-sectional sample of employees at the biggest mining company in Kyrgyzstan was interviewed during their annual medical examination. A self-administered questionnaire on attitudes towards a full smoking ban at the workplace along with questions on knowledge and attitudes regarding the current legislation was used on 1881 employees, who lived mostly in Bishek and the Issyk-Kul area. Logistic regression was used to determine the predictive role of smoking, sex, and place of residence.

Results

Participants were mostly men (87.1%), aged 38.6 ± 9.4 years. In general, the employees supported a stricter tobacco control policy in their company (59.2%), and 58.2% supported a full smoking ban at workplaces and 61.5% in dwelling rooms at the mining site. The current tobacco control Law was familiar to 63% of employees (49% women). Of 668 participants, 85% indicated full support for the smoking ban in public places, and 77% supported full prohibition of smoking in places where smoking was currently partially banned. Smokers were less likely to support a full smoking ban in places with a current partial ban (OR 0.52; 0.35–0.75).

Conclusions

The level of awareness of the tobacco control legislation was very low among Kyrgyzstan mining employees. They supported the full smoking ban in places where smoking was already prohibited and a full smoking ban in places where smoking was currently only restricted.

The burden of cardiovascular disease (CVD) is likely to increase dramatically in Asia over the next several decades. In this paper, we review the existing data on CVD epidemiology in Asia, with a focus on the INTERHEART study and the Asia Pacific Cohort Studies Collaboration. Existing data suggests that much of CVD may be preventable through reduction in the levels of well-established CVD risk factors and that these findings are likely to be relevant to Asian populations. However, these studies have several important limitations. These include a lack of longitudinal studies with collection of repeated measures of CVD risk factors and the environmental factors that may result in the age-related increase in the levels of these risk factors. As such, the natural history of the development of CVD risk factors such as obesity, diabetes, hypertension and dyslipidemia in Asia, and their relationship in terms of duration and timing of exposure to various environmental influences is currently unknown. In addition, there is a paucity of data related to psychosocial factors that may be involved in the pathogenesis of CVD, either directly or through effects on other CVD risk factors. Finally, little data is available with regards to the impact of CVD and its attendant risk factors on health related quality of life and health care utilization. This information is crucial for the design and evaluation of evidence based programs for primary prevention. We have designed a LIFE Course Study in CARdiovascular disease Epidemiology (LIFECARE) involving 12,000 individuals in four South East Asian countries to address these data needs.