Mean values of risk factors for ischemic heart disease and their percentile distributions in the Alma-Ata population of men aged 20-54]

The authors analyze the results of a one-stage epidemiological study of the open population of men aged 20-54 years (n-2886), carried out with a purpose of revealing coronary heart disease (CHD) and its risk factors (RF). The study was performed with the aid of the standard WHO methods of epidemiological investigations. The prevalence of the main CHD RF (arterial and borderline hypertension, overweight, tobacco-smoking, dyslipoproteinemias) was established. The mean values of RF in different age groups were calculated. The regional 90% cut-off points of RF distributions were defined: the body weight index (30.0), systolic arterial pressure (141 mm Hg), diastolic arterial pressure (95 mm Hg), cholesterol level (6.50 mmol/l, triglycerides (2.15 mmol/l). The 10% cut-off point for alpha-cholesterol amounted to 0.98 mmol/l. The regional values obtained can be used in prophylactic screenings when making up groups to be placed under dispensary observation.     

Epidemiologic aspects of tobacco smoking in connection with its clinical course among men aged 20-69 years living in Kiev

An epidemiological study was carried out among 1500 men aged 20-69 years in order to study the prevalence of risk factors of coronary heart disease. 51.1% of the men turned out to be tobacco-smokers. Every tenth man smoked up over 20 cigarettes, every fourth man smoked up from 10 to 20 cigarettes a day. The number of tobacco-smokers decreased with age, namely from 61% at an age of 20-29 years to 33% at an age of 60-69 years. The structure of tobacco-smoking was found to change with age. This is related to the fact that the age-associated dynamics of its prevalence and intensity correlates with the dynamics of formation and course of the toxicomanic dependence on tobacco smoke. The data obtained are important for the planning of measures aimed at tobacco-smoking control among the population in cases where it is necessary to estimate whether carrying out of the sanitary instructive measures alone is sufficient.     

动态心电图筛查睡眠呼吸暂停综合征在冠心病中的应用

目的应用动态心电图(DCG)观察冠心病(CHD)患者中睡眠呼吸暂停综合征(SAS)的发生情况,分析SAS与CHD及其危险因素之间的关系。方法选取因胸痛于本院心内科住院并行冠状动脉造影检查的患者共166例,根据造影结果分为CHD组和对照组。所有患者均进行DCG检查,并应用DCG筛查SAS。结果 166例患者中确诊CHD100例(CHD组),66例除外CHD(对照组)。CHD组的男/女性别比例高于对照组,差异有统计学意义(P0.05),年龄、腹围、糖尿病患病率、估计的呼吸暂停低通气指数(Est.AHI)、SAS发生率亦明显高于对照组,差异有统计学意义(P0.01)。CHD组有38.0%合并SAS,而对照组SAS的发生率仅为18.2%。Logistic回归分析显示Est.AHI水平、性别、年龄与CHD发病独立相关,且危险性从大到小依次为Est.AHI水平、年龄和性别。结论 CHD患者中SAS的发生率较高,SAS是CHD的独立危险因素;应用DCG筛查CHD患者中的SAS是可行的,具有一定的临床实用价值。     

The estimated risk for coronary heart disease and prevalence of dyslipidemia among workers of information technology industries in Taiwan

BackgroundIndividuals working in information technology (IT) industries suffer from high work stress, possibly causing adverse impacts on their health. However, studies of cardiovascular risk factors among these workers are lacking. The aims of this study were to evaluate the estimated risk for coronary heart disease (CHD) and prevalence of dyslipidemia among IT workers.MethodsA total of 941 employees from 11 IT companies were enrolled and the anthropometrics and serum lipid profiles were measured. The 10-year risk for CHD was calculated based on the Framingham risk score.ResultsCompared with lipid profiles in a representative sample (n = 6589), IT workers had a significantly higher prevalence of obesity, hypercholesterolemia, low level of HDL-C, and high level of LDL-C in each age group. Their overall estimated 10-year risk for CHD was higher than the average risk of an age- and gender-matched population (2.91% vs. 2.79%, p = 0.027). Working for more than 10 h/day was associated with a higher estimated CHD risk (3.62% vs. 2.54%, p < 0.01).ConclusionsA higher prevalence of hyperlipidemia was noted among IT workers. Their estimated 10-year CHD risk was also higher than average. More aggressive interventions to reduce the risk of CHD in this population are needed.     

Prevalence of cardiovascular disorders among the elderly in primary care in Estonia

OBJECTIVE: To assess the prevalence of diagnoses of cardiovascular disorders among the elderly in family practice. DESIGN: Cross-sectional study. SETTING: Estonia, population aged 65 years or older (206,915 persons). SUBJECTS: 811 elderly persons selected randomly from the lists of family practitioners. MAIN OUTCOME MEASURES: Prevalence of hypertension, hypotension, coronary heart disease (CHD), myocardial infarction (MI), heart failure (HF) and cardiac arrhythmias; differences between the genders and age groups. RESULTS: The prevalence of cardiovascular disorders was as follows: hypertension 63.2%, hypotension 11.1%, CHD 56.5%, MI 9.8%, HF 41.4% and arrhythmias 37.5%. Women had a significantly higher prevalence of hypertension and men of MI. The prevalence of CHD and hypotension was significantly higher in the oldest elderly persons. CONCLUSION: Among the older population in Estonia, cardiovascular disorders that have broader diagnostic criteria and need expensive methods for verifying (CHD, HF) have a high prevalence and are most likely over-diagnosed. The need for strict and simple diagnostic methods for these disorders in primary care practice continues to be serious.     

Arterial hypertension: its prevalence, risk factors and the priority trends in its prevention]

All male population aged 40-59 years (n = 7413) of small towns of Lithuania underwent an epidemiological survey. Of these, 5204 persons (70.2% of the group) responded. The prevalence of arterial hypertension was determined (32.7%) as was its relation to three risk factors and five sociodemographic parameters. A more pronounced positive correlation was established between the incidence of arterial hypertension and overweight, a pronounced one between AH and alcohol use and tobacco-smoking giving up, and a partial one between AH and educational level, official standing, and salary. Recommendations as to prevention of and priority trends in further studies into arterial hypertension are under discussion.     

Second-trimester ductus venosus measurement and adverse perinatal outcome in fetuses with congenital heart disease.

OBJECTIVE: The purpose of this study was to determine whether Doppler velocimetry of the ductus venosus (DV) predicts adverse perinatal outcome in congenital heart disease (CHD). METHODS: We conducted a retrospective cohort study of all pregnant women undergoing fetal echocardiography for CHD in a single perinatal center during a 2-year period. We compared outcomes for fetuses having a diagnosis of CHD in the second trimester and abnormal DV Doppler velocimetric findings with those having CHD and normal DV Doppler findings. Karyotype, gestational age at delivery, fetal loss rate, and rate of termination were assessed. The referral value for an abnormal DV pulsatility index was above the 95th percentile for gestational age. Statistical analysis included the t test, Fisher exact test, and chi(2) test. RESULTS: The incidence of CHD in our population was 7%. There were 98 patients with CHD; of those, 31 had DV measurement. A total of 9 patients had an abnormal DV. Three of this group (33%) had intrauterine fetal death or perinatal death. In patients with CHD and normal DV measurements, 83% had living children versus 33% in the group with an abnormal DV (P < .05). There was no statistically significant difference in the rate of aneuploidy between the normal DV (15%) and abnormal DV (20%) groups (P = .65). The mean gestational age at delivery was similar between the normal (37.63 weeks) and abnormal (38.33 weeks) DV groups (P = .71). There was no difference in the rate of pregnancy termination. CONCLUSIONS: Abnormal second-trimester DV measurements are predictive of adverse perinatal outcome in patients with CHD, independent of karyotype or gestational age at delivery. This information may have a role in the counseling of parents with CHD.     

Coronary heart disease incidence in NIDDM patients in the Helsinki Heart Study.

OBJECTIVE--To determine coronary heart disease (CHD) incidence among dyslipidemic subjects with non-insulin-dependent diabetes mellitus (NIDDM) and to assess the effect of lipid-modifying treatment on serum and lipoprotein lipids and the CHD incidence in these patients. RESEARCH DESIGN AND METHODS--Of the 4081 men participating in the Helsinki Heart Study, a coronary primary prevention trial with gemfibrozil in middle-aged men with high non-high-density lipoprotein (HDL) cholesterol (greater than 5.2 mM; 200 mg/dL), 135 had NIDDM at entry. The incidence of definite myocardial infarction and cardiac death and changes in serum and lipoprotein lipids were determined during the 5-yr trial in the NIDDM patients and compared with those observed in nondiabetic trial participants. RESULTS--Compared with nondiabetic subjects, NIDDM patients had lower HDL cholesterol (P less than 0.001), higher triglyceride concentration (P less than 0.0001), and greater body mass index (P less than 0.001), there were more hypertensive patients (P less than 0.001) among them. The incidence of myocardial infarction and cardiac death was significantly higher among diabetic than nondiabetic participants (7.4 vs. 3.3%, respectively, P less than 0.02). CHD incidence in the gemfibrozil-treated diabetic men (n = 59) was 3.4% compared with 10.5% in the placebo group (NS). In multivariate analysis, diabetes (P less than 0.05), age (P less than 0.0001), smoking (P less than 0.0001), low HDL cholesterol (P less than 0.05), and high low-density lipoprotein cholesterol (P less than 0.005) were independently related to CHD incidence. Gemfibrozil-induced serum and lipoprotein lipid changes in diabetic patients were similar to those observed in nondiabetic subjects. CONCLUSIONS--Compared with similarly dyslipidemic nondiabetic subjects, patients with NIDDM are at markedly increased risk of CHD. This elevated risk can be somewhat reduced by gemfibrozil.     

Increased plasma markers of oxidative stress are associated with coronary heart disease in males with diabetes mellitus and with 10-year risk in a prospective sample of males

BACKGROUND: Increased oxidative stress is associated with coronary heart disease (CHD). We examined the association between plasma markers of oxidative stress and CHD in a cross-sectional sample of patients with diabetes and prospective CHD risk in a sample of men predominantly without diabetes. METHODS: Plasma total antioxidant status (TAOS) and the ratio of oxidized LDL (Ox-LDL) to LDL-cholesterol (LDL-C) were determined in a cross-section of 761 Caucasian individuals with diabetes (UDACS study). Plasma TAOS was also determined in 310 baseline samples from a 10-year prospective cohort of 3012 healthy males (NPHSII). RESULTS: Within UDACS, males with CHD had lower mean (SD) plasma TAOS [no CHD, 43.4 (13.2)%; CHD, 40.3 (13.8)%; P = 0.04]. The prevalence of CHD was higher in the lowest compared with the upper quartiles (32.7% vs 19.7%; P = 0.004). We observed a significant association between plasma Ox-LDL:LDL-C and CHD status [no CHD vs CHD, 16.9 (3.1) vs 19.3 (5.0) units/mmol; P = 0.04], with the prevalence of CHD being higher among men in the upper compared with lower quartiles (18.4% vs 35.1%; P = 0.003). No association was observed in females. In NPHSII, TAOS was lower in those who developed CHD [35.1 (8.0)% vs 37.1 (7.9)%; P = 0.04]. The odds ratio for CHD in the lowest compared with the upper quartile was 1.91 (95% confidence interval, 0.99-3.70; P = 0.04). This remained unchanged after adjustment for classic risk factors. CONCLUSIONS: A cross-sectional and prospective association exists between baseline plasma measures of oxidative stress and CHD risk. The association with prospective CHD risk remained after adjustment for "traditional" risk factors, implying an independent role for oxidative stress in CHD risk.     

Coronary heart disease risk equivalence in diabetes depends on concomitant risk factors

OBJECTIVE: Diabetes has been defined as a coronary heart disease (CHD) risk equivalent, and more aggressive treatment goals have been proposed for diabetic patients. RESEARCH DESIGN AND METHODS: We studied the influence of single and multiple risk factors on the 10-year cumulative incidence of fatal and nonfatal CHD and cardiovascular disease (CVD) in diabetic and nondiabetic men and women, with and without baseline CHD or CVD, in a population (n = 4,549) with a high prevalence of diabetes. RESULTS: In both sexes, diabetes increased the risk for CHD (hazard ratio 1.99 and 2.93 for men and women, respectively). Diabetic men and women had a 10-year cumulative incidence of CHD of 25.9 and 19.1%, respectively, compared with 57.4 and 58.4% for nondiabetic men and women with previous CHD. The pattern was similar when only fatal events were considered. Diabetic individuals with one or two risk factors had a 10-year cumulative incidence of CHD that was only 1.4 times higher than that of nondiabetic individuals (14%). However, the 10-year incidence of CHD in diabetic subjects with multiple risk factors was >40%, and the incidence of fatal CHD was higher in these subjects than in nondiabetic subjects with previous CHD. Data for CVD showed similar patterns, as did separate analyses by sex. CONCLUSIONS: Our results and comparisons with other available data show wide variation in the rate of CHD in diabetes, depending on the population and existing risk factors. Most individuals had a 10-year cumulative incidence >20%, but only those with multiple risk factors had a 10-year cumulative incidence that was equivalent to that of patients with CHD. Until more data are available, it may be prudent to consider targets based on the entire risk factor profile rather than just the presence of diabetes.     

Differences in diabetes prevalence, incidence, and mortality among the elderly of four racial/ethnic groups: whites, blacks, hispanics, and asians

OBJECTIVE: To examine diabetes prevalence, incidence, and mortality from 1993 to 2001 among fee-for-service Medicare beneficiaries > or = 67 years of age. RESEARCH DESIGN AND METHODS: This study was a retrospective analysis of a 5% random sample of Medicare fee-for-service beneficiaries > or = 65 years of age in each year. RESULTS: In 1993, the prevalence of diabetes among those > or = 67 years of age was 145 cases per 1,000 individuals. By 2001, it was 197/1,000, an increase of 36.0%. The 2001 prevalence among Hispanics (334/1,000) was significantly higher than among blacks (296/1,000), Asians (243/1,000), and whites (184/1,000, P < 0.0001). During the 7-year period the greatest increase in diabetes prevalence was among Asians (68.0%). Between 1994 and 2001, the annual rate of newly diagnosed elderly individuals with diabetes increased by 36.9%. Hispanics had the greatest increase at 55.0%. The mortality rate among individuals with diabetes decreased by approximately 5% between 1994 and 2001 from 92.1/1,000 to 87.2/1,000 (P < 0.001), due to a 6% decrease among whites. No decrease in mortality was seen among elderly individuals without diabetes, it was 55/1,000 in 1994 and 54/1,000 in 2001. CONCLUSIONS: The dramatic increase in the incidence and prevalence of diabetes likely reflect a combination of true increases, as well as changes in the diagnostic criteria and increased interest in diagnosing and appropriately treating diabetes in the elderly. Improved treatment may have had an impact on mortality rates among individuals with diabetes, although they could have been influenced by the duration of diabetes before diagnosis, which has likely decreased. Changes in incidence, prevalence, and mortality in elderly individuals with diabetes need to continue to be monitored.     

Prevalence of arterial hypertension, ischemic heart disease and their risk factors in geologists in various regions of the USSR

The authors presented the results of an epidemiological survey conducted simultaneously for the first time among persons of geological professions in order to reveal the prevalence of arterial hypertension (AH) and coronary heart disease (CHD) with account of labor intensity, climatic and geographic factors. Altogether 1041 men were examined in 4 regions: in Vorkuta (a trans-polar region), Ukhta (a northern region), Chita and the Central region. The highest AH prevalence was detected in Vorkuta (27.4%), the lowest--in the Central region; the highest CHD prevalence was noted in Ukhta, the lowest--in Vorkuta. As for labor intensity, persons whose work was characterized by psychologic stress, suffered from AH and CHD more frequently. Significant differences in the prevalence of these diseases were revealed among managers and employees.     

Measures in the campaign against smoking and their efficacy according to the results of a 3-year observation under the conditions of a district polyclinic

Examination of 4185 men aged 30 to 59 years, carried out within the framework of investigations into multifactorial prevention of coronary heart disease enabled one to establish that the number of tobacco-smokers among that group men amounts to 45.1%. The percentage of tobacco-smokers appreciably decreases with age. Every second tobacco-smoker starts smoking at the age of 15 to 25 years and smokers out up to 20 and over cigarettes a day. It has been established that 86% of the tobacco-smokers have been smoking for more than 20 years, which allows attributing them to a group of persons suffering from stage III-IV tobacco-smoking, needing therapeutic care. Tobacco-smoking control consisting in group and individual interviews made it possible to lower the populational level of tobacco-smoking by 8.4% for 2 years. In the reference group, that indicator decreased by 1.4%. A new narcologic method of the treatment of tobacco-smoking has been elaborated, the efficacy of which amounted to 85.3% for a year. The use of the method led to the lowering of the populational level of tobacco-smoking by 15.1% during 3 years. In the reference group, the number of tobacco-smokers dropped by 4.7%.     

Study of arterial pressure, body weight, motor activity and prevalence of smoking in two independent samples of Moscow schoolchildren 11 and 14 years of age

The paper treats the results of a comparative 6-year study of arterial blood pressure, body weight, motor activity, and tobacco-smoking prevalence with respect to two representative samples of schoolchildren aged 11 and 14 years living in one of the districts of Moscow. A total of 1999 and 1219 persons were examined. The scope of examination amounted to 88 to 93 percent. From 1978-1980 to 1985-1986 the levels of systolic and diastolic arterial blood pressure increased whereas the physical activity of the schoolchildren of the same age declined. The situation with tobacco-smoking changed towards better. Thus the number of tobacco-smoking boys aged 14 years reduced almost 2-fold in spite of the lack of any prophylactic interventions in that population.     

冠心病合并心力衰竭患者上肢浅静脉血栓发生率横断面调查及影响因素分析

目的调查冠心病(CHD)合并心力衰竭(HF)患者上肢浅静脉血栓(SVT)的发生率,并分析其影响因素。方法选取我院2017年1月至2020年2月收治的743例CHD合并HF患者作为研究对象,收集患者的一般资料及临床资料。统计CHD合并HF患者上肢SVT的发生率,并采用单因素与多因素分析影响CHD合并HF患者上肢SVT发生的因素。结果743例CHD合并HF患者经彩色多普勒超声诊断确诊SVT 376例,确诊率为50.61%(376/743),其中不完全阻塞315例(83.78%),完全阻塞61例(16.22%)。二元Logistic回归分析显示,年龄、静脉给药途径、单次留置针留置时间、LDL和ATⅡ是CHD合并HF患者上肢SVT发生的危险因素,SVT预防性护理是CHD合并HF患者上肢SVT发生的保护因素(P<0.05)。结论CHD合并HF患者上肢SVT的发生率较高,且影响因素较多,治疗过程中应重视对高龄、留置针穿刺、高LDL和高ATⅡ水平患者的筛查与护理,严格按照相关指南与规范控制留置针留置时长,以减少上肢SVT的发生。     

2014－2016年浙江省温州市围产儿先天性心脏病监测分析

目的 了解浙江省温州市围产儿先天性心脏病（CHD）发生率及其动态变化,为制定CHD的预防措施提供依据。方法 按全国出生缺陷监测方案要求,收集温州市围产儿CHD监测资料,每季度核对数据资料,对2014－2016年的数据资料汇总后进行统计分析。结果 3年间围产儿CHD发生率分别为0.98%、1.01%和1.42%;多胎妊娠的围产儿CHD发生率高于单胎妊娠围产儿（χ2=413.024,P<0.001）;随着孕妇年龄增大,围产儿CHD的发生率增加（χ2=62.346,P<0.001）;3年间围产儿CHD的产后诊断率呈逐年上升（χ2=130.654,P<0.001）;3年间房间隔缺损合并卵圆孔未闭、动脉导管未闭和室间隔缺损始终位居CHD种类排序前3位。结论 3年间CHD的发生率呈上升趋势,应加强出生缺陷防控体系建设,全面落实出生缺陷三级预防措施,改善出生人口健康水平。     

血尿酸与冠心病及其严重程度相关性研究

目的探讨血尿酸(SUA)与冠心病发生及其严重程度的关系以及在不同性别和年龄人群中的差异,为人群预防和临床诊治提供依据。方法根据冠状动脉造影结果将研究对象分为冠心病组396例和非冠心病组792例,根据SUA水平按四分位数将患者分为1~4组,分析不同组间冠心病患病率的差异;以发生病变的血管支数反映冠心病严重程度,分析SUA水平与病变严重程度之间的关系;采用Logistic回归分析SUA水平对冠心病的危险性。结果 (1)冠心病组SUA水平高于非冠心病组,性别分层分析后仅女性组差异仍然存在;年龄分层显示,30~70岁人群中冠心病组SUA水平明显高于非冠心病组。(2)总体、女性及30~70岁人群中,SUA浓度最高组(第4组)的冠心病患病率明显高于其余各组。(3)总体、女性及30~70岁人群中SUA水平与冠状动脉病变支数呈正相关。(4)Logistic回归分析表明,总体、女性及30~70岁人群中SUA水平为冠心病的危险因素。结论 SUA水平与冠心病的患病率有关,且与冠状动脉病变严重程度呈正相关,在女性人群和30~70岁人群中SUA对冠心病及其严重程度的预测价值更大。     

The prevalence of ischemic heart disease among an organized population of Novosibirsk

In order to study CHD prevalence in an organized population (aged 20 to 59) in Novosibirsk a simultaneous cardiological study of workers and employees at one of the factories was conducted in 1985. CHD prevalence rate among all examinees was 12.2%. The growing number of risk factors brought about an increase in the number of detected CHD cases. Particular attention should be drawn to patients with risk factors and to prophylaxis among them.     

Distribution of prenatal and postnatal risk factors for sudden infant death in Budapest

Mortality from coronary heart disease has decreased by 60% in Finland during the past 25 years. The prevalence of coronary heart disease decreased during the 1990s among the elderly. Silent myocardial infarction was common, especially in elderly women. The number of coronary angioplasty or bypass operations has increased considerably, especially in men. Objective &;#114 - &;#114 To characterise the prevalence of, and changes in, coronary heart disease (CHD) among men and women aged between 64 and 71 years in the 1990s. Design &;#114 - &;#114 A study of clinical epidemiology involving two cohorts of elderly persons in 1990 - 1991 and 1998 - 1999. Setting &;#114 - &;#114 Primary health care in the municipality of Lieto in southwestern Finland. Subjects &;#114 - &;#114 Persons between 64 and 71 years of age in the southwest of Finland in 1990-1991 and 1998-1999. Main outcome measures &;#114 - &;#114 The occurrences of CHD were estimated using the history of a previous myocardial infarction or coronary revascularisation procedure evident in the medical records and with ischaemia or infarction as established on ECG according to the Whitehall criteria. Results &;#114 - &;#114 The prevalence of 'probable' CHD decreased among men and women aged between 64 and 71 years, whereas the prevalence of 'possible' CHD decreased among women alone. Silent myocardial infarctions were common among women of both cohorts. Many more men of the second cohort, compared to the first one, had undergone a coronary angioplasty or bypass operation. Conclusion &;#114 - &;#114 The prevalence of CHD decreased among elderly women more clearly than among young elderly men. The favourable development illustrating a decrease in the prevalence of CHD among women should be sustained, while health promotion activities will need to be directed more actively towards men.     

Change in the prevalence of coronary heart disease among Finnish elderly men and women in the 1990s

OBJECTIVE: To characterise the prevalence of, and changes in, coronary heart disease (CHD) among men and women aged between 64 and 71 years in the 1990s. DESIGN: A study of clinical epidemiology involving two cohorts of elderly persons in 1990-1991 and 1998-1999. SETTING: Primary health care in the municipality of Lieto in southwestern Finland. SUBJECTS: Persons between 64 and 71 years of age in the southwest of Finland in 1990-1991 and 1998-1999. MAIN OUTCOME MEASURES: The occurrences of CHD were estimated using the history of a previous myocardial infarction or coronary revascularisation procedure evident in the medical records and with ischaemia or infarction as established on ECG according to the Whitehall criteria. RESULTS: The prevalence of 'probable' CHD decreased among men and women aged between 64 and 71 years, whereas the prevalence of 'possible' CHD decreased among women alone. Silent myocardial infarctions were common among women of both cohorts. Many more men of the second cohort, compared to the first one, had undergone a coronary angioplasty or bypass operation. CONCLUSION: The prevalence of CHD decreased among elderly women more clearly than among young elderly men. The favourable development illustrating a decrease in the prevalence of CHD among women should be sustained, while health promotion activities will need to be directed more actively towards men.