The Worldwide Environment of Cardiovascular Disease: Prevalence, Diagnosis, Therapy, and Policy Issues

Laslett, Lawrence J.; Alagona, Peter; Clark, Bernard A.; Drozda, Joseph P.; Saldivar, Frances; Wilson, Sean R.; Poe, Chris; Hart, Menolly

doi:10.1016/j.jacc.2012.11.002

Cited by 698 publications

(460 citation statements)

References 76 publications

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“…83 Thus, overall, CR is available in 83 out of the 214 (38.8%) countries worldwide. CR services are available in only 23% of the LMICs, where 80% of CVD deaths occur 84 underlining the insufficient supply of CR in countries with the greatest cardiovascular burden. There is an inverse relationship between the availability of CR and the number of patients indicated for CR therapy.…”

Section: Cr Availability In Low-income Countriesmentioning

confidence: 99%

Global availability of cardiac rehabilitation

2014

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The most prevalent non-communicable disease globally, namely cardiovascular disease (CVD), is also the leading cause of mortality, with over 80% of the deaths occurring in low-and middleincome countries. To lessen the impact of CVDs on individuals and societies, a comprehensive approach is needed. Cardiac rehabilitation (CR) involves delivery of structured exercise, education and risk reduction, in a cost-effective manner. Robust evidence demonstrates it reduces mortality up to 25%, improves functional capacity, as well as decreases re-hospitalization. Despite its benefits, and clinical practice guideline recommendations to refer cardiac patients, CR programs are grossly under-used. Worldwide, there is low availability of CR; only 38.8% of countries globally have CR programs. Specifically, 68.0% of high-income and 23% of LMICs (28.2% for middle-and 8.3% for low-income countries) have CR. CR density estimates ranged from 1 program per 0.1-6.4 million inhabitants. CR availability is much lower than that of other evidencebased secondary prevention therapies, such as revascularization and pharmacological therapies. Multi-level strategies to augment CR capacity and availability at national and international levels such as supportive public health policies, systematic referral strategies, and alternative models of delivery are needed.

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Section: Cr Availability In Low-income Countriesmentioning

confidence: 99%

Global availability of cardiac rehabilitation

2014

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“…Cardiovascular disease is the leading cause of mortality in developed countries and costs the global economy approximately US$3.7 trillion per annum [1]. As such, interventions that can lower cardiovascular disease morbidity will be of epidemiological and economic importance.…”

Section: Introductionmentioning

confidence: 99%

Improvement in blood pressure after short-term inorganic nitrate supplementation is attenuated in cigarette smokers compared to non-smoking controls

et al. 2016

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“…Cardiovascular disease (CVD) accounts for nearly half of the noncommunicable diseases leading to the global cause of mortality (1) . With increased pace of technological advancements, minimally invasive image‐guided cardiovascular interventions are gaining importance across various health‐care centers for the diagnosis of CVDs.…”

Section: Introductionmentioning

confidence: 99%

Radiation doses and estimated risk from angiographic projections during coronary angiography performed using novel flat detector

Varghese

Livingstone

Varghese

et al. 2016

J Applied Clin Med Phys

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Coronary angiography (CA) procedure uses various angiographic projections to elicit detailed information of the coronary arteries with some steep projections involving high radiation dose to patients. This study intends to evaluate radiation doses and estimated risk from angiographic projections during CA procedure performed using novel flat detector (FD) system with improved image processing and noise reduction techniques. Real‐time monitoring of radiation doses using kerma‐area product (KAP) meter was performed for 140 patients using Philips Clarity FD system. The CA procedure involved seven standard projections, of which five were extensively selected by interventionalists. Mean fluoroscopic time (FT), KAP, and reference air kerma (Ka,r) for CA procedure were 3.24 min (0.5–10.51), 13.99 Gycm2 (4.02–37.6), and 231.43 mGy (73.8–622.15), respectively. Effective dose calculated using Monte Carlo‐based PCXMC software was found to be 4.9 mSv. Left anterior oblique (LAO) 45° projection contributed the highest radiation dose (28%) of the overall KAP. Radiation‐induced risk was found to be higher in females compared to males with increased risk of lung cancer. An increase of 10%–15% in radiation dose was observed when one or more additional projections were adopted along with the seven standard projections. A 14% reduction of radiation dose was achieved from novel FD system when low‐dose protocol during fluoroscopy and medium‐dose protocol during cine acquisitions were adopted, compared to medium‐dose protocol.PACS number(s): 87.50.cm, 87.55.de, 87.55.N, 87.59.cf, 87.59.Dj

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The Worldwide Environment of Cardiovascular Disease: Prevalence, Diagnosis, Therapy, and Policy Issues

Cited by 698 publications

References 76 publications

Global availability of cardiac rehabilitation

Global availability of cardiac rehabilitation

Improvement in blood pressure after short-term inorganic nitrate supplementation is attenuated in cigarette smokers compared to non-smoking controls

Radiation doses and estimated risk from angiographic projections during coronary angiography performed using novel flat detector

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