Prevalence Rates Of Coronary Heart Disease Research Articles

The effectiveness of pre-operative care bundle on post-operative outcome among adult patients undergoing cardiac surgeries in selected hospitals

Background: Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other conditions. More than four out of five CVD deaths are due to heart attacks and strokes, and one-third of these deaths occur prematurely in people under 70 years of age. India has one of the highest burdens of cardiovascular disease (CVD) worldwide. The annual number of deaths from CVD in India is projected to rise from 2.26 million (1990) to 4.77 million (2020). Coronary heart disease prevalence rates in India have been estimated over the past several decades and have ranged from 1.6% to 7.4% in rural populations and from 1% to 13.2% in urban populations.Purpose: To determine the effectiveness of preoperative care packages on postoperative outcomes of CABG patients and the relationship of postoperative outcomes with clinical and demographic variables.Method: In this study, the design used was a quasi-experimental design. In this study, a simple random sampling technique was used. sample size was 40 (experimental group 20 and control group 20) Study Findings 95% of patients were diagnosed with TVD, the remaining 5% were DVD patients.Results: This shows that there is moderate with 30% and good with 70% recovery in the experimental group, while in the control group 85% is moderate, 10% is good and 5% is bad. This indicates that there is a significant difference between the postoperative outcome scores between the experimental and control groups as p<0.05Conclusion: there is a significant effect of a pre-operative care bundle in patients undergoing CABG on preventing CABG complications and increasing life expectancy.

Add-on effect of Nagabala–Arjunadi yoga on left ventricular ejection fraction and New York Heart Association functional capacity in post- myocardial infarction – An experience

Cardiovascular Diseases (CVDs), especially Coronary Heart Disease (CHD), are epidemic in India. The annual number of deaths from CVD in India is projected to rise from 2.26 million (1990) to 4.77 million (2020). CHD prevalence rates in India have been estimated over the past several decades and have ranged from 1.6% to 7.4% in the rural population and from 1% to 13.2% in the urban population. Myocardial Infarction (MI) is the most common form of CHD. Many clinical and laboratory factors, such as persistent ischemia and depressed Ejection Fraction (EF), have been identified with an increase in cardiovascular risk after initial recovery from MI. Even though conventional medicines are excellent life-saving measures in MI, quality of life is always a concern. A 56-year-old male, presented to Ayurveda hospital with exertional dyspnea and pain in the chest for one year, following secondary prevention, and had two episodes of documented MI in 2017 and 2020, respectively. Two-dimensional echocardiography (dated July 15, 2021) revealed septal and apical wall hypokinesia and an EF of 50%. The two month intervention with Nagabala–Arjunadi yoga improved the EF to 10 percentiles (5%), and wall motion abnormality was reduced to a physiological limit. The overall status of the New York Heart Association classification was improved from Class II to Class I. The quality of life assessed by the MacNew questionnaire also showed a significant difference. This case report revealed that the Ayurvedic internal medication is helpful in improving the post-MI functional capacity of the patient.

Abstract 694: The Impact of Glucose-Lowering Therapy and Lifestyle-Related Factors on Vascular Disease Risk Reduction in Younger and Older Adults: National Trend and New Evidence from Big Data

Objective: To examine the independent and interaction impacts of glucose-lowering therapy and lifestyle-related factors (obesity and hypercholesterolemia) on vascular disease risk reduction in patients with type 2 diabetes mellitus (T2DM). Methods: Data from 1999 to 2012 National Health and Nutrition Examination Surveys in participants aged≥30 years old (n=29064) were analyzed. T2DM was classified by self-reported physician diagnosis and those who were under glucose-lowering therapy. Coronary heart disease (CHD), stroke, and hypercholesterolemia (H-TC) were classified by self-reported physician diagnosis. Obesity was defined by BMI≥30 (weight(kg)/height squared(m 2 )). Results: The prevalence of T2DM significantly increased from 8% in 1999 to 12.3% in 2012 in subjects aged <65 (p<.001), and from 19.8% to 26.1% in subjects aged≥65 (p<.0001). In logistic regression analysis, after adjustment for age, sex, race, education, obesity and H-TC, T2DM patients with glucose-lowering therapy had significantly lower risk of CHD (OR=0.76, 95%CI: 0.60-0.97, p=0.025) than those without glucose-lowering therapy. A further stratification analysis indicated a significant combined and dose-response effect of glucose-lowering therapy and body weight on the risk of CHD. Obese patients without glucose-lowering therapy had the highest prevalence rate of CHD, and non-obese patients with glucose-lowering therapy had the lowest rate in patients aged<65 (17.7% vs. 10.9%, a 38% reduction, p=0.035), and in those aged≥65 (37.0% vs. 28.0%, a 24% reduction, p=0.029). A significant effect of glucose-lowering therapy with non H-TC on CHD was also observed. A similar protective effect of glucose-lowering therapy with non-obesity and non H-TC on stroke was observed as well, although this association did not reach statistically significant. Conclusion: using a 14-year nationally representative data, the study provides new evidence that a drug-lifestyle interaction effect of glucose-lowering therapy and diet-related factors plays a significant role in CHD risk reduction in patients with T2DM, and this effect could be even greater in younger adults than that in the older.

Spectrum of Cardiovascular Diseases in Asian-American Racial/Ethnic Subgroups

To compare the prevalence of coronary heart disease (CHD), stroke, and peripheral vascular disease (PVD) across Asian-American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, andVietnamese) and non-Hispanic white (NHW) subjects in a mixed-payer, outpatient health care organization in California. Electronic health records from 2007 to 2010 were examined for 94,423 Asian and NHW patients. Age-adjusted prevalence rates of CHD, stroke, and PVD, defined by physician International Classification of Diseases, Version 9, codes, were directly standardized to the NHW population. Age-adjusted odds ratios were calculated by the use of logistic regression for each Asian subgroup, by sex, compared with NHWs. The range of age-adjusted prevalence rates were: CHD (1.7%-5.2%), stroke (0.3%-1.8%), and PVD (0.9%-3.4%). The adjusted odds ratios of CHD were significantly higher for Filipino women (1.66; 95% confidence interval; 1.13-2.43) and men (1.47, 1.05-2.06) and Asian Indian men (1.77, 1.43-2.21), and significantly lower for Chinese women (0.72, 0.55-0.94) and men (0.78, 0.65-0.93), compared with NHWs. The odds of stroke were significantly greater for Filipino women (2.02, 1.22-3.34). The odds of PVD were generally lower for all Asian subgroups. There is considerable heterogeneity across Asian subgroups for prevalent CHD, stroke, and PVD. Future research should disaggregate Asian subgroups and cardiovascular outcomes to inform targeted prevention and treatment efforts.

Clustering of Unconventional Cardiovascular Risk Factors among Taiwanese Hemodialysis Patients

Background: Cardiovascular disease (CAVD) is the most common cause of mortality for chronic hemodialysis (HD) patients, yet the risk factors for the events have not been well established. Methods: We conducted a multicenter cross-sectional survey in 995 chronic HD patients recruited from 12 HD centers in Taiwan to investigate the prevalence of CAVD, including coronary heart disease (CHD), cerebrovascular disease (CVD), and peripheral vascular disease (PVD), and related them to 30 different parameters. Results: The mean age of 995 patients (499 males/496 females) was 56.4 ± 12.3 years, and average HD duration was 59.8 ± 51.2 months. The prevalence rates of CHD, CVD, and PVD were 24.0, 6.0, and 5.3%, respectively. Results of our multivariate logistic regression analysis showed that out of the conventional CAVD risk factors, only old age and diabetes could be significantly associated with CAVD. Meanwhile, we found some novel clinical correlates, including low apolipoprotein A-I and creatinine for CHD, low uric acid for CVD, and low hematocrit and low diastolic blood pressure for PVD. Interestingly, left ventricular hypertrophy was found to be an independent correlate for all three: CHD, CVD, and PVD. Conclusions: Our study suggests that consideration of conventional cardiovascular risk factors as well as unconventional risk factors might better assess the risk for CAVD among HD patients.

Estimating CHD prevalence by small area: Integrating information from health surveys and area mortality

The risk of coronary heart disease (CHD) is strongly linked both to deprivation and ethnicity and so prevalence will vary considerably between areas. Variations in prevalence are important in assessing health care needs and how far CHD service provision and surgical intervention rates match need. This paper uses a regression model of prevalence rates by age, sex, region and ethnicity from the 1999 and 2003 Health Surveys for England to estimate CHD prevalence for 354 English local authority areas. To allow for the impact of social factors on prevalence, survey information on the deprivation quintile in the respondents’ micro-area of residence is also used. Allowance is also made for area CHD mortality rates (obtained from aggregated vital statistics data) which are positively correlated with, and hence a proxy for, CHD prevalence rates. An application involves assessment of surgical intervention rates in relation to prevalence at the level of 28 Strategic Health Authorities.

Reflection in the arterial system and the risk of coronary heart disease

Background Although it was reported that the augmentation index and inflection time are closely related to reflection in the arterial system and large artery function, it is not known whether these indices of the ascending aortic pressure waveform increase the risk of coronary heart disease (CHD). The purpose of this study was to evaluate whether the aortic reflection of the ascending aortic pressure waveform is related to an increased risk of CHD. Methods We enrolled 190 men and women who had chest pain, normal contractions, no local asynergy, and no history of myocardial infarction. We measured the ascending aortic pressure using a fluid-filled system. The inflection time was defined as the time interval from initiation of a systolic pressure waveform to the inflection point. We investigated the association between the inflection time and augmentation index of the ascending aorta and the risk of CHD. Results Both the inflection time and augmentation index were associated with an increased risk of CHD. The crude prevalence rates of CHD were 66.0% for the shortest quartile and 10.6% for the longest quartile of the inflection time, and 17.0% for the lowest quartile and 40.4% for the highest quartile of the augmentation index. The multiple-adjusted odds ratio of CHD was 30.8 (95% confidence interval [CI] 7.43–128.05) for the shortest quartile of the inflection time compared with the longest quartile and was 3.82 (95% CI 1.26–11.59) for the highest quartile of the augmentation index compared with the lowest quartile. Conclusions The augmentation index and inflection time were associated with an increased risk of CHD.

Coronary heart disease, type 2 diabetes mellitus and cardiovascular disease risk factors: a study on a middle-aged and elderly population

The risk for all the manifestations of atherosclerotic disease is increased in patients affected by type 2 diabetes mellitus. The aim of the present work was to evaluate the prevalence of coronary heart disease (CHD) in a well-characterized middle-aged and elderly Italian diabetic population. The population studied included 3862 subjects, i.e. all the patients affected by type 2 diabetes of age ≥50 years attending the outpatient diabetes care unit of INRCA in Ancona (Italy) from 1 August 1997 to 31 July 1998. We collected and analysed both clinical and laboratory data by means of a computerized data base for the outpatient clinic management. The prevalence rate of CHD was 20.25% in this population. The groups with CHD and without CHD did not differ significantly with respect to age at onset of diabetes, body mass index and HbA1c levels, while patients with CHD were significantly older than patients without CHD and had a longer duration of diabetes. The prevalence of patients with hypertension (52.9 vs 63.0%, P<0.001), hypercholesterolemia (11.6 vs 14.1%, P<0.05) and hyperlipidemia (17.8 vs 23.3%, P<0.001) was significantly higher in the group of diabetic subjects affected by CHD than in patients not affected by heart ischemic disease. It might be hypothesized that the improvement of metabolic profile and the currently feasible control of non-diabetic risk factors could reduce cardiovascular disease rates in type 2 diabetic patients.

Prevalence of coronary heart disease and major cardiovascular risk factors in Thailand.

Coronary heart disease (CHD) is expected to become one of the major health problems in developing countries such as Thailand where prevalence data are scarce. This study reports the prevalence of CHD, as indicated by electrocardiogram (ECG) Minnesota coding, and its risk factors in Thailand. In 1991 we conducted a cross-sectional ECG survey in a multistage random sample of the Thai population, aged > or =30. All major cardiovascular risk factors were measured. Standard supine 12-lead ECG data were collected; amplitudes and intervals were measured manually and entered into a computer. Abnormal tracings were verified by five cardiologists, and agreement among at least three of them was accepted as final. The total sample included 3822 men and 4967 women aged > or =30 years. The age-standardized prevalence rate of CHD was 9.9/1000 (men 9.2/1000, women 10.7/ 1000). The age-standardized level of major cardiovascular risk factors among men and women respectively were: total cholesterol 4.8 mmol/l (187.3 mg/dl), 5.1 mmol/l (197.7 mg/dl); hypercholesterolaemia (> or =6.2 mmol/l) 12.2%, 16.9%; systolic blood pressure (mmHg) 117.8, 117.7; diastolic blood pressure (mmHg) 76.9, 75.8; body mass index (kg/m2) 21.7, 22.8; fasting blood sugar 4.8 mmol/l (87.9 mg/dl), 5.0 mmol/l (90.3 mg/dl); hypertension (> or =160/95 +/- on antihypertensive drugs) 6.3%, 8.1%; smoking 65.1%, 8.5%; diabetes mellitus (> or =7.8 mmol/l) 2.4%, 3.7%; obesity (>25 kg/m2) 15.2%, 27.2%. Most of the age-adjusted mean values and proportion of major cardiovascular disease risk factors as well as the prevalence of total CHD in the Thai population were much lower than the median of those values found in developing countries.

Diabetes and coronary heart disease in American Indians: The Strong Heart Study.

Coronary heart disease (CHD) is the leading cause of death among American Indians. However, information on the prevalence of CHD and its association with known risk factors is limited. The purpose of the Strong Heart Study is to quantify CHD and its risk factors among three geographically diverse groups of American Indians. The population consists of 4,549 adults between 45 and 74 years of age in 13 Indian communities in Arizona, Oklahoma, and South and North Dakota. The phase I examination (1989-1991) revealed very high prevalence rates of diabetes that ranged from 33 to 72% in men and women in the three centers. Prevalence rates of definite myocardial infarction (MI) and definite CHD were higher in men than in women in all three centers (P < 0.0001) and in those with diabetes (P = 0.002 and P = 0.0003 in women and men respectively). Diabetes was associated with a relatively greater increase in prevalence of MI (prevalence rate = 3.8 vs. 1.9) and CHD (prevalence rate = 4.6 vs. 1.8) in women than in men. Logistic regression analysis indicated that the prevalence of CHD among American Indians was significantly related to age, diabetes, hypertension, albuminuria, percentage of body fat, smoking, high concentrations of plasma insulin, and low concentrations of HDL cholesterol. Lower prevalence rates of CHD were found in Arizona despite higher rates of diabetes, obesity, hypertension, and albuminuria; these lower rates may be in part related to lower smoking frequency and lower concentrations of total and LDL cholesterol. These findings from the baseline Strong Heart Study examination emphasize the relative importance of diabetes and its associated variables as risk factors for CHD among American Indian populations.

Factors Predictive of Long-Term Coronary Heart Disease Mortality among 10,059 Male Israeli Civil Servants and Municipal Employees

Over 10,000 male civil servants and municipal employees in Israel, aged 40 years and above, underwent an extensive clinical, biochemical, anthropometric, sociodemographic and psychosocial evaluation in 1963, 1965 and 1968. Follow-up for mortality was continued through 1986. Over 23 years, a number of previously established risk factors for coronary heart disease (CHD) incidence were found to predict mortality. The long-term follow-up assisted in illustrating temporal patterns. A single causal assessment of blood pressure retained high prediction for long-term mortality. Blood lipids, while significantly associated with both coronary and all-cause mortality, exhibited a small contribution to the latter, when compared to hypertension, cigarette smoking habits and diabetes. Weak associations of long-term coronary mortality with the dietary intake patterns of fatty acids, as reported at baseline, were probably fully mediated by the effect of the diet on serum cholesterol. Religious orthodoxy appeared to provide a degree of immunity, part of which was independent of life-style correlates. A number of now well-established associations in cardiovascular epidemiology were first demonstrated, or amplified, in the study. Patterns of ethnic diversity in the risk factor and prevalence rates of CHD persisted, as viewed from the angle of mortality rates, over nearly a quarter of a decade, highlighting the enigma of a migrant country as a cardiovascular melting pot.

Trends in CHD and Risk Factors at Age 55-64 in the Framingham Study

In a preliminary analysis to assess secular changes in cardiac morbidity, mortality, and risk factors in the Framingham Heart Study, there is a suggestion of decline in coronary heart disease (CHD) mortality in women but not in men. For subjects age 55 to 64 in 1953, 1963 and 1973, the ten-year CHD mortality rates per 1000 were 93, 84 and 99 for men; and 34, 39, and 24 for women, respectively. In contrast, CHD prevalence rates have increased significantly for men (102, 134 and 159 per 1000) and marginally for women (55, 65 and 69 per 1000). Incidence of CHD increased slightly in men (187, 210 and 208 per 1000 over the three decades) and decreased in women (131, 132, 110). Some coronary risk factors improved, while others changed unfavourably.

Prevalence of coronary heart disease in an urban population in northern India.

A prevalence survey of coronary heart disease (CHD) was carried out in a north Indian town involving a house-to-house clinical and electrocardiographic examination of all the 2,030 persons above the age of 30 years residing in the area. The sample is considered adequate and representative of urban population of northern India. The diagnosis of CHD was based on history of myocardial infarction or angina pectoris and electrocardiographic abnormalities according to criteria used by Epstein and associates. 1 The prevalence rates of CHD for men and women were similar to those found in Tecumseh. 1 The prevalence of CHD increased with age, with socio-economic status, with the sedentary nature of occupation, and in hypertensives. Those with CHD were more obese than others, and the prevalence showed a positive correlation with subscapular skinfold thickness in men. Sixty-two per cent of the men and 88% of the women had clinically silent CHD. No comparable published data on prevalence of CHD in the general population in India is available.