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Total cardiovascular risk approach to improve efficiency of cardiovascular prevention in resource constrain settings

Abstract Objectives To determine the population distribution of cardiovascular risk in eight low- and middle-income countries and compare the cost of drug treatment based on cardiovascular risk (cardiovascular risk thresholds ≥30%/≥40%) with single risk factor cutoff levels. Study Design and Setting... Full description

Journal Title: Journal of clinical epidemiology 2011, Vol.64 (12), p.1451-1462
Main Author: Mendis, Shanthi
Other Authors: Lindholm, Lars H , Anderson, Simon G , Alwan, Ala , Koju, Rajendra , Onwubere, Basden J.C , Kayani, Azhar Mahmood , Abeysinghe, Nihal , Duneas, Alfredo , Tabagari, Sergo , Fan, Wu , Sarraf-Zadegan, Nizal , Nordet, Porfirio , Whitworth, Judith , Heagerty, Anthony
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0895-4356
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recordid: cdi_swepub_primary_oai_DiVA_org_umu_50405
title: Total cardiovascular risk approach to improve efficiency of cardiovascular prevention in resource constrain settings
format: Article
creator:
  • Mendis, Shanthi
  • Lindholm, Lars H
  • Anderson, Simon G
  • Alwan, Ala
  • Koju, Rajendra
  • Onwubere, Basden J.C
  • Kayani, Azhar Mahmood
  • Abeysinghe, Nihal
  • Duneas, Alfredo
  • Tabagari, Sergo
  • Fan, Wu
  • Sarraf-Zadegan, Nizal
  • Nordet, Porfirio
  • Whitworth, Judith
  • Heagerty, Anthony
subjects:
  • Adult
  • Aged
  • Aged, 80 and over
  • Armed Forces
  • Arterial hypertension. Arterial hypotension
  • Atherosclerosis
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Cardiology
  • Cardiology. Vascular system
  • Cardiovascular disease
  • Cardiovascular diseases
  • Cardiovascular Diseases - economics
  • Cardiovascular Diseases - epidemiology
  • Cardiovascular Diseases - etiology
  • Cardiovascular Diseases - prevention & control
  • China - epidemiology
  • Cost saving
  • Cost-Benefit Analysis
  • Cross-Sectional Studies
  • Cuba - epidemiology
  • Developing Countries - economics
  • Epidemiology
  • Female
  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
  • Georgia - epidemiology
  • Health policy
  • Health Resources - economics
  • Health Resources - supply & distribution
  • Health Sciences
  • Heart attacks
  • Humans
  • Hypercholesterolemia - epidemiology
  • Hypercholesterolemia - prevention & control
  • Hypertension
  • Hypertension - epidemiology
  • Hypertension - prevention & control
  • Hälsovetenskaper
  • Internal Medicine
  • Iran - epidemiology
  • Male
  • Medical and Health Sciences
  • Medical colleges
  • Medical sciences
  • Medicin och hälsovetenskap
  • Middle Aged
  • Miscellaneous
  • Mortality
  • Nepal - epidemiology
  • Nigeria - epidemiology
  • Pakistan - epidemiology
  • Patient Selection
  • Prevention
  • Prevention and actions
  • Preventive cardiology
  • Public health
  • Public Health, Global Health, Social Medicine and Epidemiology
  • Public health. Hygiene
  • Public health. Hygiene-occupational medicine
  • Risk
  • Risk Assessment
  • Risk Factors
  • Sri Lanka - epidemiology
  • World Health Organization
ispartof: Journal of clinical epidemiology, 2011, Vol.64 (12), p.1451-1462
description: Abstract Objectives To determine the population distribution of cardiovascular risk in eight low- and middle-income countries and compare the cost of drug treatment based on cardiovascular risk (cardiovascular risk thresholds ≥30%/≥40%) with single risk factor cutoff levels. Study Design and Setting Using World Health Organization (WHO) and the International Society of Hypertension risk prediction charts, cardiovascular risk was categorized in a cross-sectional study of 8,625 randomly selected people aged 40–80 years (mean age, 54.6 years) from defined geographic regions of Nigeria, Iran, China, Pakistan, Georgia, Nepal, Cuba, and Sri Lanka. Cost estimates for drug therapy were calculated for three countries. Results A large fraction (90.0–98.9%) of the study population has a 10-year cardiovascular risk
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0895-4356
fulltext: fulltext
issn:
  • 0895-4356
  • 1878-5921
  • 1878-5921
url: Link


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titleTotal cardiovascular risk approach to improve efficiency of cardiovascular prevention in resource constrain settings
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creatorMendis, Shanthi ; Lindholm, Lars H ; Anderson, Simon G ; Alwan, Ala ; Koju, Rajendra ; Onwubere, Basden J.C ; Kayani, Azhar Mahmood ; Abeysinghe, Nihal ; Duneas, Alfredo ; Tabagari, Sergo ; Fan, Wu ; Sarraf-Zadegan, Nizal ; Nordet, Porfirio ; Whitworth, Judith ; Heagerty, Anthony
creatorcontribMendis, Shanthi ; Lindholm, Lars H ; Anderson, Simon G ; Alwan, Ala ; Koju, Rajendra ; Onwubere, Basden J.C ; Kayani, Azhar Mahmood ; Abeysinghe, Nihal ; Duneas, Alfredo ; Tabagari, Sergo ; Fan, Wu ; Sarraf-Zadegan, Nizal ; Nordet, Porfirio ; Whitworth, Judith ; Heagerty, Anthony
descriptionAbstract Objectives To determine the population distribution of cardiovascular risk in eight low- and middle-income countries and compare the cost of drug treatment based on cardiovascular risk (cardiovascular risk thresholds ≥30%/≥40%) with single risk factor cutoff levels. Study Design and Setting Using World Health Organization (WHO) and the International Society of Hypertension risk prediction charts, cardiovascular risk was categorized in a cross-sectional study of 8,625 randomly selected people aged 40–80 years (mean age, 54.6 years) from defined geographic regions of Nigeria, Iran, China, Pakistan, Georgia, Nepal, Cuba, and Sri Lanka. Cost estimates for drug therapy were calculated for three countries. Results A large fraction (90.0–98.9%) of the study population has a 10-year cardiovascular risk <20%. Only 0.2–4.8% are in the high-risk categories (≥30%). Adopting a total risk approach and WHO guidelines recommendations would restrict unnecessary drug treatment and reduce the drug costs significantly. Conclusion Adopting a total cardiovascular risk approach instead of a single risk factor approach reduces health care expenditure by reducing drug costs. Therefore, limited resources can be more efficiently used to target high-risk people who will benefit the most. This strategy needs to be complemented with population-wide measures to shift the cardiovascular risk distribution of the whole population.
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subjectAdult ; Aged ; Aged, 80 and over ; Armed Forces ; Arterial hypertension. Arterial hypotension ; Atherosclerosis ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology ; Cardiology. Vascular system ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - economics ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - prevention & control ; China - epidemiology ; Cost saving ; Cost-Benefit Analysis ; Cross-Sectional Studies ; Cuba - epidemiology ; Developing Countries - economics ; Epidemiology ; Female ; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ; Georgia - epidemiology ; Health policy ; Health Resources - economics ; Health Resources - supply & distribution ; Health Sciences ; Heart attacks ; Humans ; Hypercholesterolemia - epidemiology ; Hypercholesterolemia - prevention & control ; Hypertension ; Hypertension - epidemiology ; Hypertension - prevention & control ; Hälsovetenskaper ; Internal Medicine ; Iran - epidemiology ; Male ; Medical and Health Sciences ; Medical colleges ; Medical sciences ; Medicin och hälsovetenskap ; Middle Aged ; Miscellaneous ; Mortality ; Nepal - epidemiology ; Nigeria - epidemiology ; Pakistan - epidemiology ; Patient Selection ; Prevention ; Prevention and actions ; Preventive cardiology ; Public health ; Public Health, Global Health, Social Medicine and Epidemiology ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Risk ; Risk Assessment ; Risk Factors ; Sri Lanka - epidemiology ; World Health Organization
ispartofJournal of clinical epidemiology, 2011, Vol.64 (12), p.1451-1462
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8Duneas, Alfredo
9Tabagari, Sergo
10Fan, Wu
11Sarraf-Zadegan, Nizal
12Nordet, Porfirio
13Whitworth, Judith
14Heagerty, Anthony
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descriptionAbstract Objectives To determine the population distribution of cardiovascular risk in eight low- and middle-income countries and compare the cost of drug treatment based on cardiovascular risk (cardiovascular risk thresholds ≥30%/≥40%) with single risk factor cutoff levels. Study Design and Setting Using World Health Organization (WHO) and the International Society of Hypertension risk prediction charts, cardiovascular risk was categorized in a cross-sectional study of 8,625 randomly selected people aged 40–80 years (mean age, 54.6 years) from defined geographic regions of Nigeria, Iran, China, Pakistan, Georgia, Nepal, Cuba, and Sri Lanka. Cost estimates for drug therapy were calculated for three countries. Results A large fraction (90.0–98.9%) of the study population has a 10-year cardiovascular risk <20%. Only 0.2–4.8% are in the high-risk categories (≥30%). Adopting a total risk approach and WHO guidelines recommendations would restrict unnecessary drug treatment and reduce the drug costs significantly. Conclusion Adopting a total cardiovascular risk approach instead of a single risk factor approach reduces health care expenditure by reducing drug costs. Therefore, limited resources can be more efficiently used to target high-risk people who will benefit the most. This strategy needs to be complemented with population-wide measures to shift the cardiovascular risk distribution of the whole population.
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4Arterial hypertension. Arterial hypotension
5Atherosclerosis
6Biological and medical sciences
7Blood and lymphatic vessels
8Cardiology
9Cardiology. Vascular system
10Cardiovascular disease
11Cardiovascular diseases
12Cardiovascular Diseases - economics
13Cardiovascular Diseases - epidemiology
14Cardiovascular Diseases - etiology
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16China - epidemiology
17Cost saving
18Cost-Benefit Analysis
19Cross-Sectional Studies
20Cuba - epidemiology
21Developing Countries - economics
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25Georgia - epidemiology
26Health policy
27Health Resources - economics
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29Health Sciences
30Heart attacks
31Humans
32Hypercholesterolemia - epidemiology
33Hypercholesterolemia - prevention & control
34Hypertension
35Hypertension - epidemiology
36Hypertension - prevention & control
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39Iran - epidemiology
40Male
41Medical and Health Sciences
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46Miscellaneous
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49Nigeria - epidemiology
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titleTotal cardiovascular risk approach to improve efficiency of cardiovascular prevention in resource constrain settings
authorMendis, Shanthi ; Lindholm, Lars H ; Anderson, Simon G ; Alwan, Ala ; Koju, Rajendra ; Onwubere, Basden J.C ; Kayani, Azhar Mahmood ; Abeysinghe, Nihal ; Duneas, Alfredo ; Tabagari, Sergo ; Fan, Wu ; Sarraf-Zadegan, Nizal ; Nordet, Porfirio ; Whitworth, Judith ; Heagerty, Anthony
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1Aged
2Aged, 80 and over
3Armed Forces
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5Atherosclerosis
6Biological and medical sciences
7Blood and lymphatic vessels
8Cardiology
9Cardiology. Vascular system
10Cardiovascular disease
11Cardiovascular diseases
12Cardiovascular Diseases - economics
13Cardiovascular Diseases - epidemiology
14Cardiovascular Diseases - etiology
15Cardiovascular Diseases - prevention & control
16China - epidemiology
17Cost saving
18Cost-Benefit Analysis
19Cross-Sectional Studies
20Cuba - epidemiology
21Developing Countries - economics
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40Male
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45Middle Aged
46Miscellaneous
47Mortality
48Nepal - epidemiology
49Nigeria - epidemiology
50Pakistan - epidemiology
51Patient Selection
52Prevention
53Prevention and actions
54Preventive cardiology
55Public health
56Public Health, Global Health, Social Medicine and Epidemiology
57Public health. Hygiene
58Public health. Hygiene-occupational medicine
59Risk
60Risk Assessment
61Risk Factors
62Sri Lanka - epidemiology
63World Health Organization
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abstractAbstract Objectives To determine the population distribution of cardiovascular risk in eight low- and middle-income countries and compare the cost of drug treatment based on cardiovascular risk (cardiovascular risk thresholds ≥30%/≥40%) with single risk factor cutoff levels. Study Design and Setting Using World Health Organization (WHO) and the International Society of Hypertension risk prediction charts, cardiovascular risk was categorized in a cross-sectional study of 8,625 randomly selected people aged 40–80 years (mean age, 54.6 years) from defined geographic regions of Nigeria, Iran, China, Pakistan, Georgia, Nepal, Cuba, and Sri Lanka. Cost estimates for drug therapy were calculated for three countries. Results A large fraction (90.0–98.9%) of the study population has a 10-year cardiovascular risk <20%. Only 0.2–4.8% are in the high-risk categories (≥30%). Adopting a total risk approach and WHO guidelines recommendations would restrict unnecessary drug treatment and reduce the drug costs significantly. Conclusion Adopting a total cardiovascular risk approach instead of a single risk factor approach reduces health care expenditure by reducing drug costs. Therefore, limited resources can be more efficiently used to target high-risk people who will benefit the most. This strategy needs to be complemented with population-wide measures to shift the cardiovascular risk distribution of the whole population.
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