scholarly journals Secondary Prevention of Coronary Heart Disease in Primary Health Care

2006 ◽  
Vol 6 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Olivera Batić-Mujanović ◽  
Muharem Zildžić ◽  
Azijada Beganlić
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Primary Health Care ◽  
Secondary Prevention ◽  
Ace Inhibitors ◽  
Lipid Lowering ◽  
Primary Health

Significant increase in mortality from coronary heart disease (CHD) has been seen in Bosnia and Herzegovina in the past decade. Little is known about current secondary preventive practices and treatments among patients with CHD in primary health care. The aims of this study were to evaluate the components of secondary prevention for CHD and to detect possible gender differences. This trial included 70 patients, aged 40-70 years, with established CHD from Family Medicine Teaching Center Tuzla. We evaluated components of secondary prevention(serum total cholesterol and blood pressure levels, smoking habits, body mass index, using aspirin, ACE inhibitors and lipid lowering drugs) in all participants. Results showed that significantly more men than women had diagnosis of CHD. 26/70 (37.14%) patients had myocardial infarction, with significantly higher number of men than women, but more women had angina only. Mean systolic blood pressure was 148.09+/-20.22 and diastolic 91.62+/-10.17 mmHg; mean total cholesterol level was 6.23+/-1.33 mmol/l; mean BMI was 27.9+/-3.32 kg/m(2). Blood pressure was managed according to guidelines in 19 (27.14%), and lipid concentrations in 11 (15.71%) patients. 55/70 (78.71%) patients took aspirin, only 18/70 (25.71%) patients took lipid lowering therapy, and 20/23 (86.96%) patients with heart failure took ACE inhibitors. 16/70 (22.86%) patients were current smokers, only 19/70 (27.14%) patients had healthy body mass index, while 21/70 (30%) patients were obese. Results of this study show a suboptimal secondary prevention in primary health care, which indicate more effective public health messages and changes in the healthcare system that promotes preventive strategies.

Disparities in Secondary Prevention between Stroke and Coronary Heart Disease in China: Cross-Sectional Community-Based Study, 2014–2016

2021 ◽  
pp. 1-10
Author(s):  
Shijun Xia ◽  
Chi Wang ◽  
Xin Du ◽  
Lizhu Guo ◽  
Jing Du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Lipid Lowering ◽  
Community Based ◽  
Cross Sectional ◽  
History Of ◽  
Cvd Prevention

<b><i>Background:</i></b> Health care quality and insurance coverage have improved with economic development in China, but the burden of cardiovascular diseases (CVDs) continues to increase with ongoing gaps in prevention. We aimed to compare the uptake of secondary CVD prevention between stroke and coronary heart disease (CHD) patients in China. <b><i>Methods:</i></b> In a cross-sectional community-based survey of 47,841 adults (age ≥45 years) in 7 regions of China between 2014 and 2016, we identified those with a history of stroke or CHD to quantify disparities in conventional secondary CVD prevention strategies in multivariable logistic regression models. <b><i>Results:</i></b> There were 4,105 and 1,022 participants with a history of stroke and CHD, respectively. Compared to participants with CHD, those with a history of stroke were significantly less likely to be taking blood-pressure-lowering (39.7% vs. 53%), lipid-lowering (13.7% vs. 36.8%), and antiplatelet (20.8% vs. 50.6%) agents, at least one (48.9% vs. 70.8%) or all 3 recommended medicines (6.1% vs. 24.0%), and were less likely to achieve a lipid-cholesterol target (30.3% vs. 44.0%). Participants with a history of stroke achieved less optimal secondary prevention goals for medication use, either from any (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.44–0.66) or all 3 medications (aOR 0.27, 95% CI 0.20–0.36), as well as better blood pressure (aOR 0.81, 95% CI 0.66–0.98) and low-density lipoprotein cholesterol (aOR 0.34, 95% CI 0.27–0.43) levels of control. There were no significant differences in weight, smoking, or physical activity between the groups. <b><i>Conclusion:</i></b> Stroke patients had lower use of secondary CVD-preventive medication and achieved lower levels of risk factor control than those of CHD patients in China. Nationwide disease-specific strategies, and better education of participants and health care providers, may narrow these gaps.

scholarly journals The effect of problem-based learning after coronary heart disease – A randomised study in primary health care (COR-PRIM)

2019 ◽  
Author(s):  
Anita Kärner Köhler ◽  
Tiny Jaarsma ◽  
Pia Tingström ◽  
Staffan Nilsson
Keyword(s):  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Primary Health Care ◽  
Patient Information ◽  
Patient Empowerment ◽  
Problem Based Learning ◽  
Primary Health ◽  
One Year ◽  
Experimental Group

Abstract Background The hypothesis tested was that one year of problem-based learning (PBL) improves patients’ self-efficacy, and empowerment to change self-care significantly compared to one year of standardised home-sent patient information after an event of coronary heart disease (CHD). Methods We randomly assigned 157 patients (78% male; age 68±8.5 years) with CHD verified by percutaneous coronary intervention (PCI) (70.1%) or coronary artery by-pass surgery (CABG) and CABG+PCI or myocardial infarction (29.9%) to either PBL (experimental group; n = 79) or home-sent patient information group (controls; n = 78). The PBL intervention consisted of a patient education in primary health care by trained district nurses who tutored groups of 6-9 patients on 13 occasions over one year. Controls received home- sent patient information on 11 occasions during the study year. Results At the one-year follow-up, the primary outcome, patient empowerment, did not significantly differ between the experimental group and controls. We found no significant differences between the groups regarding the secondary outcomes e.g. self-efficacy, although we found significant differences for body mass index (BMI) [-0.17 (SD 1.5) vs. 0.50 (SD 1.6), P=0.033 ], body weight [-0.83 (SD 4.45 vs. 1.14 kg (SD 4.85), P=0.026 ] and HDL cholesterol [0.1 (SD 0.7) vs. 0.0 mmol/L (SD 0.3), P=0.038 ] for the experimental group compared to controls. Conclusions The PBL and the home-sent patient information interventions had similar results regarding patient empowerment. However, PBL exhibited significant effects on weight loss, BMI, and HDL cholesterol levels, indicating that the PBL intervention positively affected risk factors compared to the home-sent patient information intervention. Trial registration : NCT01462799 (August 2019, date last accessed) Keywords: Problem-based learning, Coronary Heart Disease, Primary Health Care, Patient empowerment, Risk factors, Self-care

Metabolic syndrome in outpatients receiving antipsychotic therapy in routine clinical practice: A cross-sectional assessment of a primary health care database

2008 ◽  
Vol 23 (2) ◽  
pp. 100-108 ◽  
Author(s):  
Antoni Sicras-Mainar ◽  
Milagrosa Blanca-Tamayo ◽  
Javier Rejas-Gutiérrez ◽  
Ruth Navarro-Artieda
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Primary Health Care ◽  
Hdl Cholesterol ◽  
Cross Sectional ◽  
Primary Health ◽  
Health Care Database ◽  
Care Database

AbstractObjectiveTo determine the prevalence of metabolic syndrome (MS) in outpatients treated with antipsychotics included in a primary-health-care database.MethodsA cross-sectional study was carried out assessing an administrative outpatients claim-database from 5 primary-health-centers. Subjects on antipsychotics for more than 3 months were included. The control group was formed by the outpatients included in the database without exposition to any antipsychotic drugs. MS was defined according to the modified NCEP-ATP III criteria, and required confirmation of at least 3 of the 5 following components: body mass index >28.8 kg/m2, triglycerides >150 mg/ml, HDL-cholesterol <40 mg/ml (men)/<50 mg/ml (women), blood pressure >130/85 mmHg, and fasting serum glucose >110 mg/dl.ResultsWe identified 742 patients [51.5% women, aged 55.1 (20.7) years] treated with first- or second-generation antipsychotics during 27.6 (20.3) months. Controls were 85.286 outpatients [50.5% women, aged 45.5 (17.7) years]. MS prevalence was significantly higher in subjects on antipsychotics: 27.0% (95% CI, 23.8–30.1%) vs. 14.4% (14.1–14.6%); age- and sex-adjusted OR = 1.38 (1.16–1.65, P < 0.001). All MS components, except high blood pressure, were significantly more prevalent in the antipsychotic group, particularly body mass index >28.8 kg/m2: 33.0% (29.6–36.4%) vs. 17.8% (17.6–18.1%), adjusted OR = 1.63 (1.39–1.92, P < 0.001), and low HDL-cholesterol levels: 48.4% (44.8–52.0%) vs. 29.3% (29.0–29.6%); adjusted OR = 1.65 (1.42–1.93, P < 0.001). Compared with the reference population, subjects with schizophrenia or bipolar disorder (BD), but not dementia, showed a higher prevalence of MS.ConclusionsCompared with the general outpatient population, the prevalence of MS was significantly higher in patients with schizophrenia or BD treated with antipsychotics.

scholarly journals Association of Features of Primary Health Care With Coronary Heart Disease Mortality

JAMA ◽  
2010 ◽  
Vol 304 (18) ◽  
Author(s):  
Louis S. Levene ◽  
Richard Baker ◽  
M. John G. Bankart ◽  
Kamlesh Khunti
Keyword(s):  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Primary Health Care ◽  
Coronary Heart Disease Mortality ◽  
Primary Health ◽  
Disease Mortality
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