Social Determinants of Cardiovascular Diseases

Jeemon, Panniyammakal; Reddy, K. Srinath

doi:10.1201/b23266-16

Cited by 4 publications

(7 citation statements)

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“…It is also striking that the 90 day HF mortality is highest in individuals with low educational status with a clear inverse relationship between educational level and mortality. A similar association has been noted in acute coronary syndrome registries 23 and several other studies in India 24–26 . Surprisingly, this inverse relationship persists in the NHFR even after adjustment for traditional factors associated with mortality including GDMT.…”

Section: Discussionsupporting

confidence: 82%

“…A similar association has been noted in acute coronary syndrome registries 23 and several other studies in India. [24][25][26] Surprisingly, this inverse relationship persists in the NHFR even after adjustment for traditional factors associated with mortality including GDMT. A relatively high mortality in women, especially in the group who did not receive medications as per GDMT is also a cause of concern.…”

Section: Discussionmentioning

confidence: 95%

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Clinical profile and 90 day outcomes of 10 851 heart failure patients across India: National Heart Failure Registry

et al. 2022

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Aims Limited data on the uptake of guideline-directed medical therapies (GDMTs) and the mortality of acute decompensated HF (ADHF) patients are available from India. The National Heart Failure Registry (NHFR) aimed to assess clinical presentation, practice patterns, and the mortality of ADHF patients in India. Methods and resultsThe NHFR is a facility-based, multi-centre clinical registry of consecutive ADHF patients with prospective follow-up. Fifty three tertiary care hospitals in 21 states in India participated in the NHFR. All consecutive ADHF patients who satisfied the European Society of Cardiology criteria were enrolled in the registry. All-cause mortality at 90 days was the main outcome measure. In total, 10 851 consecutive patients were recruited (mean age: 59.9 years, 31% women). Ischaemic heart disease was the predominant aetiology for HF (72%), followed by dilated cardiomyopathy (18%). Isolated right HF was noted in 62 (0.6%) participants. In eligible HF patients, 47.5% received GDMT. The 90 day mortality was 14.2% (14.9% and 13.9% in women and men, respectively) with a re-admission rate of 8.4%. An inverse relationship between educational class based on years of education and 90 day mortality (high mortality in the lowest educational class) was observed in the study population. Patients with HF with reduced ejection fraction and HF with mildly reduced ejection fraction who did not receive GDMT experienced higher mortality (log-rank P < 0.001) than those who received GDMT. Baseline educational class, body mass index, New York Heart Association functional class, ejection fraction, dependent oedema, serum creatinine, QRS > 120 ms, atrial fibrillation, mitral regurgitation, haemoglobin levels, serum sodium, and GDMT independently predicted 90 day mortality. Conclusion One of seven ADHF patients in the NHFR died during the first 90 days of follow-up. One of two patients received GDMT. Adherence to GDMT improved survival in HF patients with reduced and mildly reduced ejection fractions. Our findings call for innovative quality improvement initiatives to improve the uptake of GDMT among HF patients in India.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 95%

Clinical profile and 90 day outcomes of 10 851 heart failure patients across India: National Heart Failure Registry

et al. 2022

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“…The literature shows an association between low socioeconomic status and low education with greater morbidity in cardiovascular diseases. (44,45) Regarding ACS clinical and electrocardiographic presentation, NSTEMI was the most observed in this study. In the literature, STEMI incidence is also higher, regardless of gender.…”

Section: Discussionmentioning

confidence: 66%

“…In the United States, this type of acute myocardial infarction (AMI) accounts for 70% of ACS cases. (45)(46)(47) Retrospective, multicenter study compared male patients vs. female in terms of baseline characteristics, coronary ndings and inhospital and long-term prognosis and showed 79.9% of female patients with NSTEMI, while in males this number was 71.5% (p < 0.0001). (48) This study included participants who had already experienced cardiac catheterization, i.e., a repeat procedure, and participants who were having this experience in an unprecedented way.…”

Section: Discussionmentioning

confidence: 99%

Education and Music Intervention to Reduce Anxiety: feasibility, potential efficacy and patient satisfaction in a pilot study

Batista,

de Oliveira,

Reis

et al. 2024

Preprint

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Background People undergoing cardiac catheterization experience anxiety. Musical and educational interventions have been tested separately and have been shown to reduce anxiety in this patient profile. This pilot study aimed to assess the feasibility and potential effectiveness of a complex intervention called Education and Music Intervention to Reduce Anxiety (EMIRA), in addition to participant credibility, expectations and satisfaction. Methods This is a randomized, blind, pilot clinical trial, carried out in an emergency department specializing in cardiology. Feasibility was assessed according to recruitment, retention, attrition and recruitment time rates. The potential for efficacy was assessed through the effect of EMIRA on state anxiety, blood pressure, heart rate, respiratory rate and chest pain intensity, comparing the intervention group (IG) and control group (CG) before (T1), immediately after (T2) and two to four hours after (T3) the intervention. To estimate participant satisfaction with the intervention, a visual numerical scale was used. Participant credibility and expectations regarding EMIRA were determined using a previously validated instrument. The significance level adopted was 5%. Results A total of 47 potential participants were approached over a period of 54 days. Recruitment, retention, and attrition rates were, respectively, 93.6%, 90.9%, and 10%. No participant withdrew from continuing in the study after recruitment. No significant difference was observed between CG and IG in relation to the analyzed outcomes. The mean score for satisfaction, credibility and expectations were high. There was a negative correlation between satisfaction and the difference in SBP between T1 and T2. Conclusions EMIRA is a complex intervention with an educational and musical component. The results suggest that a larger-scale clinical trial is feasible, participants were satisfied and had positive attitudes towards the intervention. However, EMIRA did not promote a significant change in the outcomes analyzed. Trial registration RBR-857nczs

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“…51 However, this link was not evident in most LMICs until the 1990s when CVD, previously predominant among affluent individuals, begins to increasingly affect those with low SEP due to epidemiological transition from infectious to chronic disease. 52,53 Individuals with lower SEP experience elevated risk of CVD and mortality primarily because of the higher prevalence of unhealthy behaviors, increased psychosocial stress, and limited health care access within this population. 54 Data from both LMICs and HICs consistently highlight the strong association between lower education levels and hypertension/CVD.…”

Section: Cheap and Widely Accessible Upfmentioning

confidence: 99%

Social Determinants of Health and Disparities in Hypertension and Cardiovascular Diseases

Chaturvedi,

Zhu,

Gadela

et al. 2024

Hypertension

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High blood pressure causes over 10 million preventable deaths annually globally. Populations in low- and middle-income countries suffer the most, experiencing increased uncontrolled blood pressure and cardiovascular disease (CVD) deaths. Despite improvements in high-income countries, disparities persist, notably in the United States, where Black individuals face up to 4× higher CVD mortality than White individuals. Social determinants of health encompass complex, multidimensional factors linked to an individual’s birthplace, upbringing, activities, residence, workplaces, socioeconomic and environmental structures, and significantly affect health outcomes, including hypertension and CVD. This review explored how social determinants of health drive disparities in hypertension and related CVD morbidity from a socioecological and life course perspective. We present evidence-based strategies, emphasizing interventions tailored to specific community needs and cross-sector collaboration to address health inequalities rooted in social factors, which are key elements toward achieving the United Nations’ Sustainable Development Goal 3.4 for reducing premature CVD mortality by 30% by 2030.

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Social Determinants of Cardiovascular Diseases

Cited by 4 publications

References 0 publications

Clinical profile and 90 day outcomes of 10 851 heart failure patients across India: National Heart Failure Registry

Clinical profile and 90 day outcomes of 10 851 heart failure patients across India: National Heart Failure Registry

Education and Music Intervention to Reduce Anxiety: feasibility, potential efficacy and patient satisfaction in a pilot study

Social Determinants of Health and Disparities in Hypertension and Cardiovascular Diseases

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