Cardiovascular Disease Health Care Research Articles

Quality and availability of health care for patients with cardiovascular diseases. Results of sociological research

Aim. Based on the results of a sociological survey of patients, to assess quality and availability of health care for cardiovascular diseases (CVDs) in 2020-2021 in the Russian Federation.Material and methods. In August-September 2021, 5159 patients with CVDs from 76 Russian regions were interviewed. Questionnaire (Google form) assessed the change in health care provision over the past two years, the availability of medicine provision, the prevalence and reasons for discontinuation of treatment, as well as the difficulties faced by patients.Results. Improvement in health care provision were assessed by 47,6% of the surveyed patients with CVD, worsening — by 16,6%, and 23,7% did not noted any changes. Improvements regarded diagnosis promptness (29%) and timeliness of treatment (28,5%), availability of subsidized medicines (25%) and better patient routing (21%). However, 37% of respondents did not see any improvements in health care system, or found it difficult to answer. The acute problem of access to diagnostics was considered by 24%, inaccessibility of subsidized medicines — by 17%. In addition, 24% of respondents had difficulties in obtaining specialized cardiology care in the polyclinic and 18% had difficulty in obtaining high-quality medical rehabilitation for CVD.Conclusion. In order to increase public satisfaction with the quality of care, public awareness on health maintenance and patients’ rights to receive care should be improved. In addition, possible barriers to obtaining health care should be eliminated, while consultative and diagnostic assistance and subsidized drug provision should be facilitated for receiving.

The contribution of family physicians to chronic disease management through continuity of care in Ghana.

Chronic non-communicable diseases contribute significantly to Ghana’s disease burden. Ghana’s ability to achieve universal health coverage is threatened by the rising burden of chronic non-communicable diseases. There is a high unmet need for cardiovascular diseases care, with primary health care for cardiovascular diseases not being readily available, equitable, or sensitive to the requirements of target populations. The contribution of family physicians in the management of the chronic disease burden through care continuity cannot be overemphasised. This is a short report of the implementation of a chronic care clinic by a family physician in Manna Mission Hospital, which is located in the Greater Accra region of Ghana. Before the implementation, there was no such clinic in the hospital and patients with chronic conditions who visited the facility were sometimes lost to follow-up. The clinic which commenced in January 2019 has provided care for patients with chronic non-communicable diseases to date. The most common chronic diseases managed at the clinic include hypertension and heart failure, diabetes, stroke, asthma, sickle cell disease, and joint disorders. This report gives an account of the contribution of family physicians to chronic disease burden management through continuity of care in a low-resource setting like Ghana.

Lifetime Costs of Hospitalised Cardiovascular Disease in Australia: An Incidence-Based Estimate

To estimate the incidence-based, lifetime costs of health care and productivity losses associated with cardiovascular disease (CVD) using hospital admission data from Queensland, Australia. Retrospective analysis of data on CVD health care use sourced from Queensland Hospital Admitted Patient Data Collection (QHAPDC), Emergency Department Data Collection (EDDC), Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS). Costs were estimated from the societal perspective. Study participants included patients who were first admitted to any Queensland hospital in 2010 for a CVD-related treatment. Subsequent admissions of these patients were followed until December 2015. The present value of incidence-based lifetime costs per patient were used to estimate the total costs for Australia. All costs were presented in Australian dollars at 2019 prices. The estimated lifetime health care cost of CVD was AUD$65,700 per person. Productivity loss cost was higher at AUD$75,200 per person, and total indirect lifetime costs were $140,900 per person. Scaling these costs up for the Australian population, the estimated incidence-based lifetime CVD costs for Australia were $60.5 billion ($28.2 billion in direct costs and $32.3 billion in indirect costs). Incidence-based lifetime indirect costs of CVD were higher than the direct costs. The life-time cost structure suggests that economic benefits of health care interventions for cardiovascular diseases from a societal perspective should be at least twice as large than that from a health service perspective.

Cardiovascular Diseases and Health Literacy Skills of students in the City of Yaoundé, Cameroon

Abstract Background Cardiovascular diseases will attack, from 2020 in sub-Saharan Africa, according the World Health Organization (WHO, 2018), one in two students aged 20-25. They would constitute the main public health concern for the states of this part of the continent, where the control of the skill level of the populations in health literacy (HL) still escapes the authorities in charge of public health policies. Provided that such control represents a great opportunity for better effectiveness of health promotion policies and preventive, educational and health care for cardiovascular diseases and therefore, a guarantee of good health for citizens (Beauregard, 2010). Objective Given the fact that the level of HL skills varies according to socio-political and economic contexts, according to the culture and the environment in which we find ourselves (WHO, 2013), this study seeks to describe the level of HL skills of students in link with appropriate use of the means of prevention of cardiovascular diseases. Methodology. The study concerns 500 students/ youths enrolled in secondary and university education, whose ages vary between 12 and 20 years. Based on quantitative design, the study aims to describe and report on all of the students and young people's practical experiences related to health literacy skills. Results The results indicate, in general, unequal access of students to health knowledge. In addition, the level of their skills in cardiovascular health literacy varies according to the economic capital of their family, the possession or not of an Android phone with internet connection, the level of prestige of the cultural capital of family. Conclusions The study suggests not only to encourage students to develop their health literacy skills, but also the need to put a particular emphasis within schools and universities on knowledge related to health literacy, in order to better enhance capacities of students to cope with cardiovascular health problems. Key messages The level of their skills in cardiovascular health literacy varies according to the economic capital of their family. The need to put a particular emphasis within schools and universities on knowledge related to health literacy.

Rice protein hydrolysate attenuates hydrogen peroxide induced apoptosis of myocardiocytes H9c2 through the Bcl-2/Bax pathway

Rat myocardiocytes H9c2 were pre-treated with rice protein hydrolysate and then treated with hydrogen peroxide (H2O2). The apoptosis rate and caspase-3 activity of H9c2 cells were analyzed by Flow Cytometry and Caspase Activity Detection Assay, respectively; the expressions of B cell lymphoma/leukemia-2 (Bcl-2) and Bcl-2 associated X protein (Bax) were determined by real time-PCR and Western blot. The results showed that apoptosis of H9c2 cells was alleviated in response to the treatment of rice protein hydrolysate, potentially resulting from the up-regulation of Bcl-2 and the down-regulation of Bax. The results indicated that rice protein hydrolysate attenuated the apoptosis of myocardiocytes H9c2 involving in the Bcl-2/Bax pathway during H2O2 challenge, which suggest a potential role of rice protein hydrolysate on the healthcare of cardiovascular disease, especially acute myocardial ischemia.

A Framework for Addressing Disparities in Cardiovascular Health

Health disparities are pervasive in the United States. Life expectancy remains higher in women than in men and higher in whites than in blacks by approximately 5 years. In general, the health of racial and ethnic minorities, poor and uneducated people, and those without health insurance is worse than the health of the overall population. The care of these vulnerable groups tends to be of worse overall quality because they have trouble accessing the system, because standards of care are applied to them unevenly, and because health professionals are not consistently trained in culturally sensitive approaches. These disparities have been demonstrated in all aspects of health and healthcare for cardiovascular diseases, including the use of diagnostic and therapeutic interventions, prevalence of cardiovascular risk factors, and access to health information. Examination of national surveys revealed disparities in all cardiovascular disease risk factors, hospitalizations for major cardiovascular disease, overall mortality, and quality of life. Eliminating these disparities is a major public health challenge in the United States. Their causes and underlying mechanisms, however, remain incompletely understood. The healthcare delivery system itself, access to care, quality of care received, communication barriers, individual behaviors, culture and lifestyles, and discrimination and bias all play a part. The pursuit of systems and policy changes to address these determinants remains crucial. We present a strategic framework for eliminating health disparities that takes these determinants into account and provides an opportunity for cardiovascular nurses to make an impact on this important issue.

Editorial: The cardiovascular disease epidemic: global, regional, local

correspondence Pascal Bovet, University Institute of Social and Preventive Medicine, Bugnon 5, 1005Lausanne, Switzerland. Fax: +41 21 314 7373; E-mail: pascal.bovet@inst.hospvd.chThe challenge of the cardiovascular disease epidemicis not whether it will occur at all in the developingcountries but whether we respond in time to telescopethe transition and avoid the huge burden in young andmiddle age adults. The question is not whether we canafford to invest in cardiovascular disease preventionin the developing countries, but whether we canafford not to (Ruth Bonita).This statement by the director for the surveillance of non-communicable diseases at the World Health Organization(WHO) forcefully summarizes critical issues related tocardiovascular disease (CVD) in developing countries: theupsurge of the CVD epidemic and the need for an urgentresponsetopreventanimpendingadditionalburdenthatcanhardly be afforded by low and middle-income countriesalready plagued with scarce resources and a large burden ofinfectious diseases. Global–regional–local interrelations arecentral to these considerations. Globalization fuels theepidemic even to the remotest communities by spreadingmany unhealthy behaviours and environments conducive toCVD. However, globalization can also provide powerfulmeans to tackle CVD at broad and local levels.The rise in CVD in developing countries can be bestunderstood in the light of the epidemiological transition(Omran 1971; Reddy & Yusuf, 1998), an evolutionaryframework linking demographical and social change todisease patterns. The rapid ageing of populations indeveloping countries is the first engine in the emergence ofCVD. This demographic transition results from improvedsanitation, nutrition and infectious disease control, partic-ularly in childhood, which accompany urbanization andindustrialization. Prolonged survival allows for longerexposure to CVD risk factors and this inevitably results inlarger total numbers of CVD cases. In addition to ageingpopulations, industrialization and urbanization also bringabout several changes in lifestyles such as sedentary habits,tobacco use and unfavourable dietary patterns, whichfurther increase the incidence of CVD and other chronicdiseases. While the mix between specific chronic diseases inpopulations, particularly cerebrovascular disease andischaemic heart disease, can differ substantially betweendeveloping countries, the shift from early transitiondiseases (infections and malnutrition) to late transitiondiseases (CVD and other chronic diseases) is rapid, largeand consistent among most developing countries (Yusufet al. 2001a, b).It is not often appreciated that the current CVD burdenin developing countries is already high. Approximately78% of the burden of non-communicable diseases and85% of the cardiovascular burden worldwide arose fromthe low- and middle-income countries in 1998 (WHO1999). Furthermore, the CVD burden is expected to furtherincrease significantly over the next decades. The combinedmorbidity and mortality burdens (expressed as disability-adjusted years of life lost) caused by ischaemic heartdisease and cerebrovascular disease in developing countriesare anticipated to rank first and fourth in 2020, com-pared with sixth and seventh in 1999 (WHO 2000a, b). Itis also often not realized, possibly because of very highmortality rates from other diseases, that age-specific deathrates from non-communicable diseases are higher indeveloping than developed countries (Murray & Lopez1996). For example, the probability of stroke death isseveral folds higher, at all ages, in Tanzania than in the UK(Walker et al. 2000).A number of factors could exacerbate the CVD epidemicin developing countries compared with its course inwestern countries. Urbanization in settings of povertydiffers from that which occurs in prosperous economies,and the vulnerability to unhealthy behaviours is likely to beincreased in a context of loose social network, stressfulwaged labour and restricted resources for public healthresponse. This points to the higher prevalence of CVD andCVD risk factors among people of low socio-economic