Non-communicable Diseases Deaths Research Articles

Extracellular vesicles in post-infarction diabetic hearts

Cardiovascular disease (CVD) is the main cause of death in non-communicable diseases. In response to myocardial infarction (MI), extracellular vesicles (EVs), large (lEVs) and small (sEVs), are released within and from the heart to facilitate intercellular communication and maintain cardiac homeostasis, transferring their content such as miRNA, to recipient cells. As diabetes increases the risk of CVD, the objective was to investigate how diabetes influences the release of cardiac EVs post-MI and to determine EV miRNA content. B6J mice were fed chow diet or high-fat diet (HFD) for 3 months and subjected to MI by permanent ligation of the left anterior descending artery. Left ventricles were harvested at different timepoints post-MI and processed for EV extraction by differential centrifugation. EVs were analysed by Tunable Resistive Pulse Sensing (TRPS), flow cytometry and Western blot (WB). RNA sequencing of cardiac EVs was performed to reveal miRNAs of interest that were upregulated in cardiac EVs of MI mice and validated in HFD mice. In control mice, release of both lEVs and sEVs was increased at 24 h and 7 d post-MI. Similarly, in HFD mice, lEVs peaked at 24 h and 7 d post-MI and this increase was greater than in chow diet mice but there were no differences in sEV release between sham and MI HFD mice. TRPS analysis revealed that diabetes does not change EV size and flow cytometry showed that they are mainly of cardiomyocyte origin. Furthermore, EVs harboured cardiomyocyte marker (Troponin T) and sEVs carried tetraspanin markers as revealed by WB. Different miRNAs were also found to be upregulated in lEVs and sEVs in MI mice. Our results show that diabetes modulates the release of both cardiac lEVs and sEVs post-MI. Furthermore, there is a difference in miRNA content between the 2 types of EVs post-MI. Further work is needed to investigate the functional impact of cardiac EVs in the diabetic heart post-MI.

Analysis of Quality of Life Parameters in a Health-Promoting Program for a Population with Cardiovascular Risk Factors: a Preliminary Study

One of the main risk factors of premature death in non-communicable diseases is physical inactivity, being as significant as hypertension, diabetes mellitus, and even smoking. It has been observed that interventions for carrying out physical activity (PA) in a communal environment have been very effective in terms of participation and adherence. The aim of this study is to prove the changes that occur on a physical level in a group of 46 patients on a regulated promotion plan for PA for health. The study consisted of a total of 15 weeks, during which a series of measurements were taken on the patients prior and post carrying out the program. There were significant changes in the undertaking of body mass index (p = 0.006), systolic and diastolic arterial pressure (p = 0.03 and p = 0.01, respectively), changes in attitude [degree of PA (METs, p ≤= 0.001)], changes in perceived quality of life (EuroQoL-VAS, p ≤= 0.001), as well as in the total number of risk factors (RFT, p = 0.03). These data confirm that a regulated program of PA is effective improving cardiovascular risk factors; improving all parameters of functional fitness studied; increasing the degree of PA; and increasing the subjective perception of patients’ health. Furthermore, it is verified that carrying out these types of programs is awarded a high degree of satisfaction by the participants.

Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non‐Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline

Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non‐Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline

Reducing Premature Mortality from Cardiovascular and Other Non-Communicable Diseases by One Third: Achieving Sustainable Development Goal Indicator 3.4.1.

Non-communicable diseases (NCDs) are the world’s leading causes of death and disability, with cardiovascular disease (CVD) accounting for half of NCD deaths. An ambitious global target established by the United Nations Sustainable Development Goals – indicator 3.4.1 – aims to reduce the risk of premature death among people aged 30–69 years from CVD, cancer, diabetes, and chronic lung disease by one third by 2030. This article reviews the science and practice informing what is required to achieve this target, identifying seven interventions that can accelerate progress: 1) tobacco control; 2) treatment to reduce cardiovascular risk; 3) reduction of dietary sodium; 4) reduction of household air pollution; 5) elimination of artificial trans fat; 6) reduction of alcohol use; and 7) prevention, detection, and treatment of cancers. Achieving the target is possible – there has already been progress in some areas, particularly related to CVD reduction – but only if there is faster, more concerted action.

Diet, nutrition and chronic disease in Mainland China

In the recent 3 decades, along with the rapid development of national economy, dietary pattern and lifestyle have undergone significant changes in Mainland China. At the same time, the major causes of disease and death in Mainland China have shifted from predominantly infectious disease and diet-related deficiency diseases to overweight/obesity and other non-communicable diseases, including hypertension, stroke, coronary heart disease, diabetes, cancers, etc. The characteristics of the dietary change are the decrease of cereal and vegetable consumption and the increase of animal foods and oil/fat consumption; although the average Chinese dietary pattern remains a plant food based diet. These dietary changes, in combination with the decrease of physical activity (sedentary life), continuous increase of tobacco and alcohol consumption have led to the rapid increase of non-communicable diseases (NCDs). The overall contribution of NCDs death to the total death of Chinese people is around 80%. Current evidences have provided enough scientific basis for placing NCDs prevention and control as the high priority in public health; although further studies on the interactions between human genome and lifestyle factors are important for improving the effectiveness of prevention and control strategies.

METABOLIC SYNDROME AMONG WOMEN USING HORMONAL CONTRACEPTIVES IN HARAR TOWN, EASTERN ETHIOPIA

Background: Metabolic syndrome is associated with the risk of developing cardiovascular disease and type 2 diabetes. Cardiovascular disease is among the most cause of death in non-communicable diseases. The use of contraceptive is incriminated to increase the risk of cardiovascular diseases and metabolic syndrome. However, there is no clear evidence and metabolic syndrome among contraceptive users is not well described. This study is therefore focused to determine the prevalence of metabolic syndrome among contraceptive users in Harar. Methods: A facility based cross sectional study was conducted from April – June 2014 to determine the prevalence of metabolic syndrome and associated factors in Harar town. 365 hormonal contraceptive users from three health centers and one hospital were consecutively included in the study. Socio-demographic data and anthropometric measurements were obtained. Venous blood was drawn from each study subjects and lipid profile and fasting serum glucose were measured photometrically. Prevalence of metabolic syndrome was determined using descriptive statistics and logistic regression analysis with 95% CI using statistical package for social science (SPSS, version 20 for windows). Result: The overall prevalence of metabolic syndrome was found to be 27.7%. Metabolic syndrome was found about 9 times more likely among women with age ≥40 years than those with age <20 years (Odds Ratio (OR) 8.571; 95% CI 1.004, 73.210, p = 0.050); about 2 times more likely among those with income >1,500 Ethiopian birr (ETB) than those with those <1,500 ETB (OR 1.637, 95% CI 1.032-2.599, p = 0.036) and about 6 times more likely among those who used hormonal contraceptive for more than 42 weeks than those who used it for 6-17.9 weeks (OR 5.897, 95% CI 2.924-11.891, p = 0.000) Conclusion: This study revealed that metabolic syndrome is high among contraceptive users and higher than the rate of metabolic syndrome among community and other healthy working population. Contraceptive users with older age, with higher income and those who used the drug for longer time were found to have more metabolic syndrome than their counter parts.

The Essentials Competencies: A Framework for Substance Use-Related Curricula.

The use of substances including alcohol, tobacco, and other drugs increases the risk for injury, noncommunicable disease, and premature death and contributes to the global burden of disease. The morbidity and mortality rates among patients with at-risk substance use point to the need for future nurses to have the requisite knowledge and competencies to provide care for this population. This article provides guidance for nurse educators in designing curricula that include content related to substance use, including screening, brief intervention, and referral to treatment. Expected outcomes for baccalaureate, master's, and doctor of nursing practice programs are informed by the corresponding American Association of Colleges of Nursing Essentials. The overall goal of this guidance for nursing education is to advance the knowledge and competencies of the future nursing workforce to address the continuum of substance use and improve the health of the nation.

Advancing non-communicable diseases research in Ghana: key stakeholders' recommendations from a symposium.

Funding for the symposium was provided by NIH Fogarty International Center-Grant number D43TW008330, under the Wits Non-Communicable Disease Research Leadership Training Program.

Abstract B033: Breast cancer and other cause of death among adult women in rural Ethiopia: Presentation and duration of suffering using the direct sisterhood method

Abstract Background: In Ethiopia, breast cancer is the leading cause of cancer morbidity and mortality among women. Studies on breast cancer death are very scarce in Ethiopia. Moreover, little is known about breast cancer compared to other causes of death in Ethiopia, particularly in a rural setting, where there is no registration about the cause of death. Hence, the present study assessed breast cancer and other deaths with a special focus on the duration of suffering in a rural setting using the direct sisterhood method. Methods: We determined the pattern of causes of death among randomly selected adult women in rural Ethiopia. A modified standard verbal autopsy (VA) questionnaire was filled and reviewed by two independent local physicians to assign causes of death; contradicting diagnoses were reviewed by a third physician. Descriptive statistics with relative frequencies and their 95% confidence intervals (CI) on the basis of the binomial distribution were used. Duration of suffering was taken from the standard verbal autopsy questionnaire. Result: The median age of breast cancer death was 37 years, younger than the other cause of death. Breast cancer deaths were the second leading neoplasm responsible for 2.7% of all deaths (95% CI 1.5%-3.7%) and among top five noncommunicable diseases death. The median duration of illness for breast cancer deaths, which accounted for only 2.7% of the total cause of death, was above one year. Reproductive neoplasms, breast cancer, and epilepsy were those three causes of deaths with the largest proportion of women (more than 70%) suffering for more than six months compared to all other causes of death. Conclusion and Recommendation: Breast cancer deaths occurred in younger age groups than other causes of death. This age is considered a young age group as compared to the country overall lifespan. The very long duration of illness for a considerable number of women has practical implications to introduce palliatives care for a cancer patient. Substantial efforts need to be made to improve the prevention and control of breast cancer in order to reduce premature death of women. Citation Format: Wondimu Ayele Manamo, Adamu Addissie Nuramo, Wienke Andreas, Fikre Enquselassi Gash, Eva J. Kantelhardt. Breast cancer and other cause of death among adult women in rural Ethiopia: Presentation and duration of suffering using the direct sisterhood method [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B033.

How’The Daily Mile™’ works in practice: responses to implementation of a daily school-based physical activity intervention

Purpose: Physical inactivity is a leading cause of non-communicable disease and early death. Only one in four children in the UK currently achieve recommended levels of physical activity but school-based interventions offer opportunity to promote physical activity to large cohorts. Despite recommendation for all UK primary schools to adopt initiatives such as ́The Daily Milé, little is known about factors relating to implementation. This study represents the second phase of a pragmatic two-phase multi-method process evaluation utilising the MRĆs framework for process evaluation of complex interventions. Objectives were to explore responses of students, parents, teaching staff and governors, following a twelve-week implementation of ́The Daily Milé and consider unexpected pathways or consequences, mediators and contextual factors affecting implementation and to identify the barriers and facilitators of sustainable implementation.’

Small-area variation of cardiovascular diseases and select risk factors and their association to household and area poverty in South Africa: Capturing emerging trends in South Africa to better target local level interventions.

BackgroundOf the total 56 million deaths worldwide during 2012, 38 million (68%) were due to noncommunicable diseases (NCDs), particularly cardiovascular diseases (17.5 million deaths) cancers (8.2 million) which represents46.2% and 21.7% of NCD deaths, respectively). Nearly 80 percent of the global CVD deaths occur in low- and middle-income countries. Some of the major CVDs such as ischemic heart disease (IHD) and stroke and CVD risk conditions, namely, hypertension and dyslipidaemia share common modifiable risk factors including smoking, unhealthy diets, harmful use of alcohol and physical inactivity. The CVDs are now putting a heavy strain of the health systems at both national and local levels, which have previously largely focused on infectious diseases and appalling maternal and child health. We set out to estimate district-level co-occurrence of two cardiovascular diseases (CVDs), namely, ischemic heart disease (IHD) and stroke; and two major risk conditions for CVD, namely, hypertension and dyslipidaemia in South Africa.MethodThe analyses were based on adults health collected as part of the 2012 South African National Health and Nutrition Examination Survey (SANHANES). We used joint disease mapping models to estimate and map the spatial distributions of risks of hypertension, self-report of ischaemic heart disease (IHD), stroke and dyslipidaemia at the district level in South Africa. The analyses were adjusted for known individual social demographic and lifestyle factors, household and district level poverty measurements using binary spatial models.ResultsThe estimated prevalence of IHD, stroke, hypertension and dyslipidaemia revealed high inequality at the district level (median value (range): 5.4 (0–17.8%); 1.7 (0–18.2%); 32.0 (12.5–48.2%) and 52.2 (0–71.7%), respectively). The adjusted risks of stroke, hypertension and IHD were mostly high in districts in the South-Eastern parts of the country, while that of dyslipidaemia, was high in Central and top North-Eastern corridor of the country.ConclusionsThe study has confirmed common modifiable risk factors of two cardiovascular diseases (CVDs), namely, ischemic heart disease (IHD) and stroke; and two major risk conditions for CVD, namely, hypertension and dyslipidaemia. Accordingly, an integrated intervention approach addressing cardiovascular diseases and associated risk factors and conditions would be more cost effective and provide stronger impacts than individual tailored interventions only. Findings of excess district-level variations in the CVDs and their risk factor profiles might be useful for developing effective public health policies and interventions aimed at reducing behavioural risk factors including harmful use of alcohol, physical inactivity and high salt intake.

Trends in premature avertable mortality from non-communicable diseases for 195 countries and territories, 1990–2017: a population-based study

The reduction by a third of premature non-communicable disease (NCD) mortality by 2030 is the ambitious target of Sustainable Development Goal (SDG) 3.4. However, the indicator is narrowly defined, including only four major NCDs (cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases) and only for people aged 30-70 years. This study focuses on premature avertable mortality from NCDs-premature deaths caused by NCDs that could be prevented through effective public policies and health interventions or amenable to high-quality health care-to assess trends at global, regional, and national levels using estimates from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2017. We reviewed existing lists of NCD causes of death that are either preventable through public health policies and interventions or amenable to health care to create a list of avertable NCD causes of death, which was mapped to the GBD cause list. We estimated age-standardised years of life lost (YLL) per 100 000 population due to premature avertable mortality from NCDs, avertable NCD cause clusters, and non-avertable NCD causes by sex, location, and year and reported their 95% uncertainty intervals (UIs). We examined trends in age-standardised YLL due to avertable and non-avertable NCDs, assessed the progress of premature avertable mortality from NCDs in achieving SDG 3.4, and explored specific avertable NCD cause clusters that could make a substantial contribution to overall trends in premature mortality. Globally, premature avertable mortality from NCDs for both sexes combined declined -1·3% (95% UI -1·4 to -1·2) per year, from 12 855 years (11 809 to 14 051) in 1990 to 9008 years (8329 to 9756) in 2017. However, the absolute number of avertable NCD deaths increased 49·3% (95% UI 47·3 to 52·2) from 23·1 million (22·0-24·1) deaths in 1990 to 34·5 million (33·4 to 35·6) in 2017. Premature avertable mortality from NCDs reduced in every WHO region and in most countries and territories between 1990 and 2017. Despite these reductions, only the Western Pacific and European regions and 25 countries (most of which are high-income countries) are on track to achieve SDG target 3.4. Since 2017, there has been a global slowdown in the reduction of premature avertable mortality from NCDs. In 2017, high premature avertable mortality from NCDs was clustered in low-income and middle-income countries, mainly in the South-East Asia region, Eastern Mediterranean region, and African region. Most countries with large annual reductions in such mortality between 1990 and 2017 had achieved low levels of premature avertable mortality from NCDs by 2017. Some countries, the most populous examples being Afghanistan, the Central African Republic, Uzbekistan, Haiti, Mongolia, Turkmenistan, Pakistan, Ukraine, Laos, and Egypt, reported both an upward trend and high levels of premature avertable mortality from NCDs. Cardiovascular diseases, cancers, and chronic respiratory diseases have been the main drivers of the global and regional reduction in premature avertable mortality from NCDs, whereas premature mortality from substance use disorders, chronic kidney disease and acute glomerulonephritis, and diabetes have been increasing. Worldwide, there has been a substantial reduction in premature avertable mortality from NCDs, but progress has been uneven across populations. Countries vary substantially in current levels and trends and, hence, the extent to which they are on track to achieve SDG 3.4. By accounting for premature avertable mortality while avoiding arbitrary age cutoffs, premature avertable mortality from NCDs is a robust, comprehensive, and actionable indicator for quantifying and monitoring global and national progress towards NCD prevention and control. None.

Awareness and Level of Knowledge in Preventing Coronary Heart Disease Among Community Sample

CHD is ranked number one as a cause of death in non-communicable diseases in Indonesia. The increasing number of people with CHD not only having an impact on mortality rates also an increase in health care needs. Adequate knowledge of the disease contributes to an accurate understanding of the disease and improves adherence to a healthy lifestyle to prevent CHD. This study aims to analyze the awareness and level of community knowledge in preventing CHD. This research was a quantitative research with descriptive analytic method. Awareness and level of knowledge about CHD were evaluated using The Heart Disease Fact Questionnaire. In this study, a total of 60 respondents were obtained through a Cluster Random Sampling in the population of people who have not been diagnosed with CHD in the Village of Timpag, Tabanan Regency, Bali. The main results of this study indicated that awareness and knowledge of the highest risk factors are smoking (89.1%) followed by a factor of high cholesterol (86.6%) and high LDL cholesterol levels (86.3%) and uncontrolled blood pressure (85.9%) and overweight (82.4%). Conversely, risk factors for diabetes (50.7%), HDL cholesterol levels (52.1%), and physical activity (53.5%) received less attention. This study found that the majority of respondents were aware of and have adequate knowledge about CHD risk factors. The results of this study can add information in the development of health promotion materials or policies as an effort to prevent CHD. Further research with a larger population needs to be done to increase public awareness of CHD.
 Index Terms— Awareness, Coronary Heart Disease, Level of Knowledge

Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective.

Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests that SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.Highlights:– The burden of non-communicable diseases including cardiovascular diseases is rising in SSA.– Levels of hypertension diagnosis, treatment, and control are low at <40%, <35%, and 10–20%, respectively, and more than 40% of patients with diabetes are not aware of their diagnosis in SSA.– SSA has 23% of the world’s prevalent rheumatic heart disease cases.– The leading causes of heart failure in SSA are hypertensive heart disease, cardiomyopathy, and rheumatic heart disease, with ischemic heart disease accounting for <10% of cases compared to >50% in high-income countries.

Risk prediction of cardiovascular diseases and comparison of two prediction models

Background: Cardiovascular diseases (CVD) are the world leading causes of death in non-communicable diseases. The aim of this study is to predict cardiovascular risk and compare two prediction models.Methods: This cross-sectional study involved 440 sample size of beverage industrial participants. The 10-year prediction was processed by World Health Organization/International Society of Hypertension (WHO/ISH) score chart and Framingham general risk score. WHO stepwise questionnaire and biomedical forms was used. Data was collected and analyzed by SPSS 16.0 version.Results: The overall CVD low risk prediction (&lt;10%) by Framingham general risk score (FGRS) and WHO/ISH score chart was 74.5%, 95.4%, respectively while the CVD elevated risk (≥10%) was 25.5%, 4.6%, respectively. Gender CVD risk (≥10%) was 16.1% of male versus 9.3% of female by FGRS while 2.7% of male versus 1.5% of female classified by WHO/ISH. CVD risk increases in both of the models with age but very much in FGRS. 8.4% of employees versus 5.2% of spouses was classified as having the risk of 10-20% by FGRS while WHO/ISH classified 2.5% of employees and 0.9% of spouses as having the risk of 10-20%. FGRS classified 11.7% of all participant as having the risk above 20% while WHO/ISH classified only 1% as having the risk above 20%. Two model’s kappa agreement level was fair or minimal interrater reliability with 0.25 with p value &lt;0.001 and the correlated receiver operating characteristic curve (ROC) curve of FGRS and WHO/ISH of 0.887 area under the curve (AUC), 0.847AUC all with a p value &lt;0.001, respectively.Conclusions: FGRS predicted more risk in participants than WHO/ISH and was with minimal kappa agreement.

Inter-correlation of risk factors among heart patients.

Cardiovascular disease is a well-known and widely studied disease. Epidemiological studies indicated that the mortality rate due to cardiovascular diseases increases every year. According to the WHO (world health organization) report, cardiovascular disease is one of the most prevalent non-communicable diseases in Saudi Arabia. Moreover, the Ministry of Health, Kingdom of Saudi Arabia, also reported that 42% of the non-communicable disease death is associated with cardiovascular disease in Saudi Arabia. Various reports suggest that heart disease is associated with several risk factors. Moreover, diabetes is one of the high-risk factors. Clinical result suggests a good association between diabetes and cardiovascular complications. In the present work, we focus on some of the important risk factors responsible for heart disease such as weight, blood pressure, age, and diabetes. A set questionnaire, which includes all the parameters associated with cardiovascular disease, was prepared. Data collected from the heart patient's records of different hospitals in Al-Qassim, Saudi Arabia. We applied statistical tools to analyze the data. Our results shows very interactive and significant pattern. We found significant inter-correlation between the different risk factors. In conclusion, the inter-correlation among different risk factors of heart disease is found. It is suggested that both pre and post-heart patients should be more concern about these risk factors. Moreover, this study can be used for further research, and, will increase people awareness regarding their healthy choice.

On the need for the development of a cancer early detection, diagnostic, prognosis, and treatment response system.

Cancer is the second leading cause of noncommunicable disease deaths in the world. In 2018, there were over 18 million new cancer cases and approximately 10 million people died from the disease globally. In 2019, almost two million new cases of cancer will be diagnosed in USA and over 600,000 people are expected to die from the disease. The incidence of cancer is expected to rise because of lifestyle changes and a rapidly aging population. Evidence suggests that early detection is critical to reducing cancer morbidity and mortality. In this paper, the development of an integrated smart wearable and biomarker detection system is proposed to help reduce cancer morbidity and mortality. The potential benefits and limitations of the system are discussed.

SP2 DISCREPANCY IN HEALTH STATE UTILITY VALUES BETWEEN COST-UTILITY ANALYSIS AND REFERENCED ORIGINAL HEALTH UTILITY STUDIES IN CARDIOVASCULAR DISEASE: A REGISTRY-BASED ANALYSIS

Cardiovascular disease (CVD) is the leading cause of noncommunicable disease deaths worldwide. CVD is associated with significant financial and humanistic burden. Cost-utility analysis (CUA) uses quality-adjusted life (QALY) as the outcome measure and is commonly used in CVD. Health state utility values (HSUVs) used in calculating QALYs play an important role in determining cost effectiveness of CVD treatments. The objective was to compare HSUVs between CUAs and referenced original HSUV studies in CVD. Tufts Cost-Effectiveness Analysis Registry is a comprehensive database including more than 7,000 CUAs studies published since 1976. We used the primary disease filter to identify all CUA studies focusing on CVD included in the registry. We reviewed and extracted original HSUV studies cited in the CUAs whenever available. The descriptions and values of health states used in the CUA were compared with those reported in the original HSUV studies to evaluate the consistency in using published HSUVs. A total of 577 CVD CUAs published between 1982 and 2016 were included in the analysis. Out of 3358 health states extracted, 642 were collected as part of the CUA and 2278 obtained from external sources. The EQ-5D (50.8%) and time trade-off (TTO) (29.1%) were the most frequently used indirect and direct methods to measure HSUVs, respectively. For the 2278 health states, only 574 (25.2%) had the same health state description and value as those in the original sources. 990 health states (43.5%) differed in both description and value for which the majority did not provide any explanation for the discrepancies. Discrepancy in the description and value for the health states between the CUA and referenced health utility studies remain an important issue in CVD. Any such discrepancy, if not justified, could affect the validity of cost effectiveness results.

Prevalence of Cardiovascular Disease Risk Factors in Shaqra, Saudi Arabia

Background: According to the report of World Health Organization (WHO), cardiovascular diseases (CVDs) accounted for most noncommunicable disease (NCD) deaths (17.5 million NCD deaths) during 2012 worldwide. Surveillance of CVD risk factors is a key strategy for effective CVD prevention. Aim: To identify the extent of CVD risk factors of developing cardiovascular disease events among Shaqra population of Saudi Arabia. Method: This community-based cross-sectional study was conducted on a total of 369 participants including 267 (72.3%) males and 102 (27.6%) females aged 18-45 years from Shaqra City of Saudi Arabia. Blood Pressure, BMI, blood glucose, smoking status and family history of CVD risk factors were estimated. Results: Prevalence of hypertension was 10.3% and diabetes 1.6%. Tobacco consumption was 24.8%. Obesity was 23.30%. Family history of HTN and DM was 50.09%. Conclusion: High prevalence of hypertension, obesity and tobacco consumption was seen in Shaqra population which will predispose to CVD risk. Campaigns to raise the awareness of CVD risk factors will boost the quality of life of the peoples and will add years to live.

Assessment of knowledge on non-communicable diseases and their screening tests among elderly population in an urban area of Bengaluru

Background: Non-communicable diseases (NCDs) are the leading cause of morbidity and premature mortality in most low and middle income countries (LMIC) around the world. Recent estimates shown that about 80% of NCDs deaths occur in LMIC and nearly three fourth of global NCDs related deaths take place after the age of 60. The knowledge of NCDs and their related screening tests among elderly is essential for early detection which reduces further development of the disease and its complications, thereby reducing the burden of health care cost. Hence, the present study was undertaken.Methods: A descriptive study was conducted among 245 study subject after obtaining informed consent. Using pre-tested structured questionnaire, information was collected regarding knowledge on NCDs and their screening tests. Results were entered in Microsoft excel and analyzed using descriptive statistics.Results: 81.6% of study subjects were aware of common NCDs. Off which only 02% were aware of 6 NCDs (out of 12 NCDs considered in this study). Regarding individual diseases, about 61.6% subjects were aware of Hypertension and 52.7% about DM. About knowledge of screening test, 69% were aware about any screening test and 58.8% were aware of screening test for hypertension and 41.6% for diabetes mellitus.Conclusions: The overall knowledge regarding NCDs and their screening tests is poor among elderly population.