Determinants of coronary artery disease risk factor management across three world regions.
SURF
coronary heart disease
determinants
risk factors
secondary prevention
Journal
Heart Asia
ISSN: 1759-1104
Titre abrégé: Heart Asia
Pays: England
ID NLM: 101542742
Informations de publication
Date de publication:
2019
2019
Historique:
received:
17
08
2018
revised:
26
11
2018
accepted:
27
11
2018
entrez:
30
4
2019
pubmed:
30
4
2019
medline:
30
4
2019
Statut:
epublish
Résumé
The SUrvey of Risk Factors (SURF) indicated poor control of risk factors in subjects with established coronary heart disease (CHD). The present study aimed to investigate determinants of risk factor management in patients with CHD. SURF recruited 9987 consecutive patients with CHD from Europe, Asia and the Middle East between 2012 and 2013. Risk factor management was summarised as a Cardiovascular Health Index Score (CHIS) based on six risk factor targets (non-smoker/ex-smoker, body mass index <30, adequate exercise, controlled blood pressure, controlled low-density lipoprotein and controlled glucose). Logistic regression models assessed the associations between determinants (age, sex, family history, cardiac rehabilitation, previous hospital admission and diabetes) and achievement of moderate CHIS (≥3 risk factors controlled). The results are presented as OR with corresponding 95% CI. A moderate CHIS was less likely to be reached by women (OR 0.90, 95% CI 0.69 to 1.00), those aged <55 years old (OR 0.62, 95% CI 0.53 to 0.76) and those with diabetes (OR 0.41, 95% CI 0.37 to 0.46). Attendance in cardiac rehabilitation was associated with better CHIS achievements (OR 1.62, 95% CI 1.42 to 1.87). Younger Asian and European patients had poorer risk factor management, whereas for patients from the Middle East age was not significantly associated with risk factor management. The availability and applicability of cardiac rehabilitation varied by region. Overall, risk factor management was poorer in women, those younger than 55 years old, those with diabetes and those who did not participate in a cardiac rehabilitation. Determinants of cardiovascular risk factor management differed by region.
Sections du résumé
BACKGROUND
BACKGROUND
The SUrvey of Risk Factors (SURF) indicated poor control of risk factors in subjects with established coronary heart disease (CHD). The present study aimed to investigate determinants of risk factor management in patients with CHD.
METHODS AND RESULTS
RESULTS
SURF recruited 9987 consecutive patients with CHD from Europe, Asia and the Middle East between 2012 and 2013. Risk factor management was summarised as a Cardiovascular Health Index Score (CHIS) based on six risk factor targets (non-smoker/ex-smoker, body mass index <30, adequate exercise, controlled blood pressure, controlled low-density lipoprotein and controlled glucose). Logistic regression models assessed the associations between determinants (age, sex, family history, cardiac rehabilitation, previous hospital admission and diabetes) and achievement of moderate CHIS (≥3 risk factors controlled). The results are presented as OR with corresponding 95% CI. A moderate CHIS was less likely to be reached by women (OR 0.90, 95% CI 0.69 to 1.00), those aged <55 years old (OR 0.62, 95% CI 0.53 to 0.76) and those with diabetes (OR 0.41, 95% CI 0.37 to 0.46). Attendance in cardiac rehabilitation was associated with better CHIS achievements (OR 1.62, 95% CI 1.42 to 1.87). Younger Asian and European patients had poorer risk factor management, whereas for patients from the Middle East age was not significantly associated with risk factor management. The availability and applicability of cardiac rehabilitation varied by region.
CONCLUSIONS
CONCLUSIONS
Overall, risk factor management was poorer in women, those younger than 55 years old, those with diabetes and those who did not participate in a cardiac rehabilitation. Determinants of cardiovascular risk factor management differed by region.
Identifiants
pubmed: 31031827
doi: 10.1136/heartasia-2018-011112
pii: heartasia-2018-011112
pmc: PMC6454324
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e011112Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Diabetes Care. 2003 Apr;26(4):991-7
pubmed: 12663562
Int J Cardiol. 2003 Sep;91(1):15-23
pubmed: 12957725
J Am Coll Cardiol. 2005 Mar 15;45(6):832-7
pubmed: 15766815
Int J Epidemiol. 2006 Aug;35(4):1025-33
pubmed: 16581818
J Gen Intern Med. 2006 Jul;21(7):711-4
pubmed: 16808771
J Clin Nurs. 2009 Dec;18(24):3401-8
pubmed: 19886876
Clin Geriatr Med. 2009 Nov;25(4):563-77, vii
pubmed: 19944261
Circulation. 2010 Feb 2;121(4):586-613
pubmed: 20089546
Heart. 2010 Nov;96(21):1744-9
pubmed: 20956490
Eur Heart J. 2011 Jun;32(11):1362-8
pubmed: 21406440
Eur J Prev Cardiol. 2013 Aug;20(4):686-91
pubmed: 22514212
Eur Heart J. 2012 Jul;33(13):1635-701
pubmed: 22555213
Cardiovasc Diabetol. 2012 May 18;11:54
pubmed: 22607105
Eur J Prev Cardiol. 2013 Oct;20(5):817-26
pubmed: 22718794
BMC Public Health. 2013 May 07;13:451
pubmed: 23647616
J Cardiovasc Nurs. 2014 Sep-Oct;29(5):454-63
pubmed: 23839574
Nat Rev Cardiol. 2014 Oct;11(10):586-96
pubmed: 25027487
Heart. 2015 Feb;101(3):222-9
pubmed: 25256148
Cochrane Database Syst Rev. 2014 Dec 12;(12):CD011273
pubmed: 25503364
Eur J Prev Cardiol. 2016 Apr;23(6):636-48
pubmed: 25687109
N Engl J Med. 2015 Apr 2;372(14):1333-41
pubmed: 25830423
Int Health. 2016 Mar;8(2):77-82
pubmed: 26208507
PLoS One. 2015 Jul 29;10(7):e0133493
pubmed: 26221962
World J Diabetes. 2015 Oct 10;6(13):1246-58
pubmed: 26468341
Int J Cardiol. 2016 Apr 15;209:284-90
pubmed: 26913370
Circulation. 2016 May 24;133(21):2103-22
pubmed: 27067230
Eur J Prev Cardiol. 2016 Jul;23(11):1202-10
pubmed: 27118362
Eur Heart J. 2016 Aug 1;37(29):2315-2381
pubmed: 27222591
Prog Cardiovasc Dis. 2016 Nov - Dec;59(3):303-322
pubmed: 27542575
Lancet. 2016 Oct 8;388(10053):1459-1544
pubmed: 27733281
Prog Cardiovasc Dis. 2017 Jun - Jul;60(1):11-20
pubmed: 28286137
Prog Cardiovasc Dis. 2017 Jun - Jul;60(1):103-114
pubmed: 28689854
Heart. 2017 Oct;103(20):1587-1594
pubmed: 28931567
BMC Cardiovasc Disord. 2017 Nov 2;17(1):276
pubmed: 29096615
J Clin Med. 2018 Sep 07;7(9):null
pubmed: 30205461