PCV27 INCREASING PREVALENCE OF HYPERTENSION IN NIGERIA:A SYSTEMATIC REVIEW FROM 1990 TO 2009

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PCV27 INCREASING PREVALENCE OF HYPERTENSION IN NIGERIA:A SYSTEMATIC REVIEW FROM 1990 TO 2009
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  13th Euro Abstracts  A345 invasive approach. The aim of this study was to assess whether in a real life setting performing acute PCI would have an impact on outcomes as length of stay (LOS) and mortality in patients hospitalized for acute coronary syndromes in Belgium. METHODS:  The average length of stay (LOS) and mortality among hospitalized patients with acute coronary syndrome were estimated using the longitudinal IMS Hospital Disease Database (year 2007), including data on 34.3% of Belgian hospital beds. Stays were identified based on ICD-9 coding and split in ST-elevated Myocardial infarction (STEMI ICD-9: 410 excluding 410.7), non-STEMI (ICD-9: 410.7-411.89) and unstable angina (ICD-9: 411.1-411.8-413.0). Invasive procedures were identified with ICD-9 codes corresponding to PCI (36.0). First stays in the calendar year were examined. Comparisons were performed using a Wilcoxon non-parametrical test for LOS and a Chi-square for mortality rates. RESULTS:  In first hospitalizations, 3,420 STEMI, 2,070 non-STEMI and 954 unstable anginas were retrieved from the database, with respectively 1,206, 504 and 28 of them being treated invasively. LOS of patients undergoing PCI was significantly lower in STEMI (6.0 vs. 9.5 days; P <  0.001) and non-STEMI (5.1 vs. 9.5; P <  0.001). Mortality in patients with PCI was lower in both STEMI (3.5% vs. 17.2%; P <  0.001) and non-STEMI (0.8% vs. 6.2%; P <  0.001). Although LOS and mortality in non-invasively treated patients were lower in hospitals without a cathlab compared to hospitals with a cathlab, both parameters were signifi-cantly higher compared to PCI treated patients. CONCLUSIONS:  Although informa-tion on the baseline characteristics of the different patients is limited, the findings of this observational study seem to support randomized clinical trials. Treatment with PCI decreases the LOS and the mortality significantly in patients with a myocardial infarction. PCV25RISK OF STROKE AND PREVENTATIVE STEPS AMONG PATIENTS DIAGNOSED WITH ATRIAL FIBRILLATION IN EUROPE Gupta S 1 , Goren A 2 , Freedman D 1 1 Kantar Health, Princeton, NJ, USA; 2 Kantar Health, New York, NY, USA OBJECTIVES:  This study examined stroke risk and prevention among European patients diagnosed with atrial fibrillation (AF). METHODS:  Data were extracted from the European 2008 National Health and Wellness Survey, an annual Internet survey of self-reported health care attitudes and behaviors among 52,524 adults in Germany, Spain, Italy, the UK, and France. Stroke risk was assessed with CHADS 2 , an index summing the presence of congestive heart failure, hypertension, age of 75 years + , diabetes mellitus, and history of prior stroke or transient ischemic attack (the latter weighted twice). Low- (CHADS 2   =  0), moderate- (1), and high- (2 + ) risk patients reported on what steps, if any, they took to prevent stroke: low fat or low sodium diet, regular exercise, smoking cessation, weight loss, blood pressure or cholesterol reduction, and use of baby aspirin, aggrenox, coumadin/warfarin, plavix, or other medications. RESULTS:  Among 508 respondents diagnosed with AF (EU prevalence of 0.97%), 198 (39%) were low, 158 (31.1%) moderate, and 152 (29.9%) high in risk for stroke. Significant differences emerged in the use of any preventative steps among low- (23.7%), moderate- (35.4%), and high- (57.2%) risk patients, P <  0.05. High-risk patients were significantly more likely than the low-risk group to take every preventative step except exercise—16.2% (low), 17.7% (moderate), 20.4% (high)—and aspirin use—11.1% (low), 13.3% (moderate), 15.8% (high). For example, cou-madin/warfarin use was higher among high- (21.1%) vs. moderate- (8.9%) and low-risk (3.0%) patients, P <  0.05. CONCLUSIONS:  In the EU, 42.8% of diagnosed AF patients at high risk for stroke took no preventative steps, and no significant dif-ferences emerged between risk groups on regular exercise and aspirin use. Only 1 in 5 high-risk patients took coumadin/warafin, while many more could benefit from prophylactic anticoagulation therapy. Higher risk correlated with higher prevention, but there remains an unmet need for increased targeted treatment of high-risk AF patients. PCV26AN EPIDEMIOLOGICAL EVALUATION OF THE INCIDENCE OF DEEP VENOUS THROMBOSIS AND PULMONARY EMBOLISM IN PATIENTS  WITH HIP OR KNEE REPLACEMENT SURGERY AND OF ITS IMPACT ON THE AVERAGE LENGTH OF STAY Chevalier P, Lamotte M IMS Health Consulting, Brussels, Belgium OBJECTIVES:  Recent clinical trials on the new anti-thrombotic agents have shown that the incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing hip or knee replacement ranges between 0.5 and 2%. This study aimed at assessing the real life incidence of DVT/PE after major orthopaedic surgery in Belgian and the impact of these complications on the length of stay based on a hospital disease database. METHODS:  The incidence of DVT/PE and the average length of stay (LOS) among patients hospitalized for hip or knee replacement surgery were estimated using the longitudinal IMS Hospital Disease Database (year 2007), including data on 34.3% of Belgian hospital beds. Stays were searched based on ICD-9-CM codes corresponding to hip replacement (81.51-81.52-81.53) and knee replacement (81.54-81.55). Occurrence of DVT/PE was identified with ICD-9 codes 451.1-451.2-453.4. It was also checked whether selected patients were administered low-molecular-weight heparin (LMWH). The impact of a DVT/PE complication on LOS was assessed through a Wilcoxon non-parametrical test. RESULTS:  A total of 9377 stays with hip replacement and 6,978 stays with knee replacement were retrieved in the database. More than 99.9% of the patients were administered LMWH in both subgroups. The number of stays with a DVT/PE episode was respectively equal to 51 and 75 within the 2 subgroups, resulting in an incidence of 0.54% in patients with hip replacement and 1.07% in patients with knee replace-ment. LOS of patients with a DVT/PE episode was more than twice as high after both hip (34.2 vs. 15.9 days; P <  0.001) and knee (24.9 vs. 12.0 days; P <  0.001) replace-ment. CONCLUSIONS:  The incidences of symptomatic DVT and PE reported in clinical trials could be confirmed based on this retrospective search. The occurrence of DVT/PE doubles LOS in patients undergoing hip or knee surgery. PCV27INCREASING PREVALENCE OF HYPERTENSION IN NIGERIA: A SYSTEMATIC REVIEW FROM 1990 TO 2009 Ekwunife O, Aguwa CN University of Nigeria, Nsukka, Enugu, Nigeria OBJECTIVES:  This study aimed at synthesizing population-based studies on preva-lence of hypertension in Nigeria from 1990 to 2009. METHODS:  Cochrane library and PubMed were searched for similar reviews using filters for systematic review. General databases as well as subject-specific databases were searched for primary studies. Manuscripts of appropriate studies were retrieved. Quality assessment scale was developed to assess the retrieved manuscript and only eligible studies were selected. Formal meta-analysis was not conducted due to heterogeneity of data. RESULTS:  A total of 55 abstracts were identified, out of which 10 full manuscripts were retrieved and used for systematic review. There was an increasing trend in preva-lence of hypertension. Hypertension prevalence in rural areas increased from 18.7% in 2003 to 22.4% in 2007. In urban areas, it increased from 23.4% in 1997 to 27.1% in 2007. In studies that combined both rural and urban populations, prevalence of hypertension increased from 14.5% in 1994 to 34.8% in 2003. There was gender difference with respect to prevalence of hypertension as males had higher prevalence of hypertension compare to females. CONCLUSIONS:  Prevalence of hypertension seems to be on the increase in Nigeria. There is a need to develop strategies to prevent, treat, and control hypertension effectively in Nigeria. PCV28CARDIOVASCULAR RISK FACTORS AMONG ASIAN INDIAN AND  WHITE ADULTS IN THE UNITED STATES Mcdonald M, Zhou J, Rubinstein E, Mardekian J Pfizer Inc, New York, NY, USA OBJECTIVES:  Current prevalence of cardiovascular risk factors are lacking among Asian Indian adults. This study contributes to our knowledge by examining current national estimates for hypertension, high cholesterol, diabetes and obesity among Asian Indian and white adults aged 20 years and older, by gender and age group. METHODS:  Cross-sectional observational study design. Analysis of adults 20 years and older surveyed in the National Health Interview Surveys (NHIS 2006–2008) (Asian Indian, n =  707, white, n =  51,769). RESULTS:  The age-standardized preva-lence of hypertension among Asian Indian adults is 21%, significantly lower than the 27% prevalence among white adults. At 27%, high cholesterol is equally prevalent in both populations. Diabetes is more prevalent among Asian Indian adults (15% vs. 7%). Asian Indian men have more than twice the rate of diabetes as white men, (17% vs.7%), and Asian Indians aged 65 years and older have a higher prevalence of dia-betes than older, white adults (28% vs. 17%). Obesity rates for Asian Indian adults aged 20–39, 40–64, and 65 +  are 10%, 16%, and 16%, respectively. Obesity rates for white adults aged 20–39, 40–64, and 65 +  are 26%, 34%, and 27%, respectively (p <  0.0001 for all but 65 +  obesity differences). CONCLUSIONS:  The age-standardized prevalence rate of high cholesterol is similar among Asian Indian and white adults. Hypertension rates are lower among Asian Indians. The prevalence of diabetes is higher in the Asian Indian population, disproportionately affecting men and older adults. Targeted approaches for diabetes disease treatment and reduction are needed. PCV29PREVALENCE, CHARACTERISTICS, AND IN-HOSPITAL OUTCOMES OF METABOLIC SYNDROME IN ACUTE CORONARY DISEASE PATIENTS IN OMAN Al-Zakwani IS 1 , Al-Rasadi K 1 , Sulaiman K 2 , Panduranga P 2 1 Sultan Qaboos University, Al-Khoudh, Oman; 2 Royal Hospital, Muscat, Oman OBJECTIVES:  To evaluate the prevalence, characteristics, and in-hospital outcomes of metabolic syndrome (MS) in acute coronary syndrome (ACS) patients in Oman. METHODS:  Data were analyzed from 1,392 consecutive patients admitted to 15 hospitals throughout Oman with the final diagnosis of ACS during May 8, 2006 to  June 6, 2006 and January 29, 2007 to June 29, 2007, as part of Gulf RACE (Registry of Acute Coronary Events). MS was defined, as stipulated by the recent ATP-III guidelines, as having 3 or more of the following abnormalities: waist circumference of ≥ 94 cm for men and ≥ 80 cm for women, high triglyceride levels (of ≥ 150 mg/dL (1.7 mmol/L) or drug treatment), low high density lipoprotein cholesterol (HDL-C) levels (of < 40 mg/dL (1.0 mmol/L) for men and < 50 mg/dL (1.3 mmol/L) for females or drug treatment), blood pressure (of ≥ 130 mmHg for systolic and/or ≥ 85 mmHg for diastolic or drug treatment), and blood sugar (of ≥ 100 mg/dL ( ≥ 5.6 mmol/L) or drug treatment). RESULTS:  The overall prevalence rate of MS in ACS patients in Oman was 66% with females being the majority (80% versus  57%; P <  0.001). MS was associated with higher median body mass index scores (27 versus  24; P <  0.001), diabetics (45% versus  19%; P <  0.001), hyperlipidemia (40% versus  23%; P <  0.001), hypertension (62% versus  34%; P <  0.001), renal impairment (9.3% versus  3.4%; P <  0.001), killip score > II (13% versus  8%; p =  0.004) and non-ST segment elevation
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