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Secondary prevention of cardiovascular disease in China.
- Source :
-
Heart (British Cardiac Society) [Heart] 2020 Sep; Vol. 106 (17), pp. 1349-1356. Date of Electronic Publication: 2020 Jan 24. - Publication Year :
- 2020
-
Abstract
- Objective: We aimed to estimate the current use of secondary prevention drugs and identify its associated individual characteristics among those with established cardiovascular diseases (CVDs) in the communities of China.<br />Methods: We studied 2 613 035 participants aged 35-75 years from 8577 communities in 31 provinces in the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, a government-funded public health programme conducted from 2014 to 2018. Participants self-reported their history of ischaemic heart disease (IHD) or ischaemic stroke (IS) and medication use in an interview. Multivariable mixed models with a logit link function and community-specific random intercepts were fitted to assess the associations of individual characteristics with the reported use of secondary prevention therapies.<br />Results: Among 2 613 035 participants, 2.9% (74 830) reported a history of IHD and/or IS, among whom the reported use rate either antiplatelet drugs or statins was 34.2% (31.5% antiplatelet drugs, 11.0% statins and 8.3% both). Among the 1 530 408 population subgroups, which were defined by all possible permutations of 16 individual characteristics, reported use of secondary prevention drugs varied substantially (8.4%-60.6%). In the multivariable analysis, younger people, women, current smokers, current drinkers, people without hypertension or diabetes and those with established CVD for more than 2 years were less likely to report taking antiplatelet drugs or statins.<br />Conclusions: The current use of secondary prevention drugs in China is suboptimal and varies substantially across population subgroups. Our study identifies target populations for scalable, tailored interventions to improve secondary prevention of CVD.<br />Competing Interests: Competing interests: HK discloses that he is a recipient of research agreements from Medtronic and from Johnson & Johnson (Janssen), through Yale, to develop methods of clinical trial data sharing; is the recipient of a grant from the Food and Drug Administration and Medtronic, through Yale, to develop methods for postmarket surveillance of medical devices; works under contract with the Centers for Medicare & Medicaid Services to develop and maintain performance measures; chairs a cardiac scientific advisory board for UnitedHealth; is a participant/participant representative of the IBM Watson Health Life Sciences Board; is a member of the Advisory Board for Element Science and the Physician Advisory Board for Aetna; and is the founder of Hugo, a personal health information platform. FAM has a contract with the American College of Cardiology for his role as the Chief Scientific Advisor of the NCDR. All other authors declare no competing interests.<br /> (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Adult
Age Factors
Aged
Alcohol Drinking adverse effects
Alcohol Drinking epidemiology
Cardiovascular Diseases diagnosis
Cardiovascular Diseases epidemiology
China epidemiology
Female
Heart Disease Risk Factors
Humans
Male
Middle Aged
Platelet Aggregation Inhibitors therapeutic use
Risk Assessment
Sex Factors
Smoking Cessation
Time Factors
Treatment Outcome
Cardiovascular Diseases prevention & control
Healthy Lifestyle
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Risk Reduction Behavior
Secondary Prevention
Subjects
Details
- Language :
- English
- ISSN :
- 1468-201X
- Volume :
- 106
- Issue :
- 17
- Database :
- MEDLINE
- Journal :
- Heart (British Cardiac Society)
- Publication Type :
- Academic Journal
- Accession number :
- 31980439
- Full Text :
- https://doi.org/10.1136/heartjnl-2019-315884