Gender differences in prevalence of myocardial infarction in rural West Texans

Background

Heart disease is the leading cause of death in the United States. Incidence rates of myocardial infarction (MI) in rural West Texas signify a lack of effective, risk-specific prevention programs. The purpose of this study was to identify gender-specific risk factors for MI in rural West Texans.

Subjects and methods

Hospital patient data for those with and without a history of MI were obtained from the Project FRONTIER database for rural West Texas counties. We used statistical software, such as SPSS, R, and WinBUGS to detect and understand the nature of MI risk factors. Statistical methods including t-tests, Chi-squared, logistic regression, and a Bayesian approach were utilized to analyze data.

Results

MI significant risk factors obtained for females were systolic blood pressure (p?=?0.002), diastolic blood pressure (p?=?0.004), pulse (p?=?0.015), and smoking (p?=?0.002). For males, these were glucose (p?=?0.022), age (p?=?0.050), body fat (p?=?0.034), and smoking (p?=?0.017). The mean risk parameter followed a normal distribution, while the precision parameter depicted skew for both sexes.

Conclusions

Gender-specific differences in MI risk factors exist, and incorporating such variables can guide relevant policymaking to reduce MI incidence in rural West Texans.

     

Colorectal cancer screening use among insured adults: Is out-of-pocket cost a barrier to routine screening?

AIM To describe the characteristics of adults who needed to see a doctor in the past year but could not due to the extra cost and assess the impact of limited financial resources on the receipt of routine fecal occult blood test, sigmoidoscopy, or colonoscopy for colon cancer screening among insured patients. METHODS Data obtained from the 2012 Behavioral Risk Factor Surveillance System included 215436 insured adults age 50-75 years. We computed frequencies, adjusted odds ratios(a ORs), and 95%CIs using SAS v9.3 software. RESULTS Nine percent of the study population needed to see a doctor in the past year but could not because of cost. The numbers were significantly higher among those aged 50-64(P 0.0001), Non-Hispanic Whites(P 0.0001), and those with a primary care physician(P 0.0001) among other factors. Adjusting for possible confounders, a ORs for not seeing the doctor in the past year because of cost were: stool occult blood test within last year a OR = 0.88; 95%CI: 0.76-1.02, sigmoidoscopy within last year a OR = 0.72; 95%CI: 0.48-1.07, colonoscopy within the last year a OR = 0.91; 95%CI: 0.81-1.02. CONCLUSION We found that the limited financial resources within the past 12 mo were significantly associated with colorectal cancer(CRC) non-screening. Patients with risk factors identified in this study should adhere to CRC guidelines and should receive financial help if needed.