Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009.
<h4>Background</h4>In Tunisia, Cardiovascular Diseases are the leading causes of death (30%), 70% of those are coronary heart disease (CHD) deaths and population studies have demonstrated that major risk factor levels are increasing.<h4>Objective</h4>To explain recent CHD tre...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0063202&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849727671962959872 |
|---|---|
| author | Olfa Saidi Nadia Ben Mansour Martin O'Flaherty Simon Capewell Julia A Critchley Habiba Ben Romdhane |
| author_facet | Olfa Saidi Nadia Ben Mansour Martin O'Flaherty Simon Capewell Julia A Critchley Habiba Ben Romdhane |
| author_sort | Olfa Saidi |
| collection | DOAJ |
| description | <h4>Background</h4>In Tunisia, Cardiovascular Diseases are the leading causes of death (30%), 70% of those are coronary heart disease (CHD) deaths and population studies have demonstrated that major risk factor levels are increasing.<h4>Objective</h4>To explain recent CHD trends in Tunisia between 1997 and 2009.<h4>Methods</h4><h4>Data sources</h4>Published and unpublished data were identified by extensive searches, complemented with specifically designed surveys.<h4>Analysis</h4>Data were integrated and analyzed using the previously validated IMPACT CHD policy model. Data items included: (i)number of CHD patients in specific groups (including acute coronary syndromes, congestive heart failure and chronic angina)(ii) uptake of specific medical and surgical treatments, and(iii) population trends in major cardiovascular risk factors (smoking, total cholesterol, systolic blood pressure (SBP), body mass index (BMI), diabetes and physical inactivity).<h4>Results</h4>CHD mortality rates increased by 11.8% for men and 23.8% for women, resulting in 680 additional CHD deaths in 2009 compared with the 1997 baseline, after adjusting for population change. Almost all (98%) of this rise was explained by risk factor increases, though men and women differed. A large rise in total cholesterol level in men (0.73 mmol/L) generated 440 additional deaths. In women, a fall (-0.43 mmol/L), apparently avoided about 95 deaths. For SBP a rise in men (4 mmHg) generated 270 additional deaths. In women, a 2 mmHg fall avoided 65 deaths. BMI and diabetes increased substantially resulting respectively in 105 and 75 additional deaths. Increased treatment uptake prevented about 450 deaths in 2009. The most important contributions came from secondary prevention following Acute Myocardial Infarction (AMI) (95 fewer deaths), initial AMI treatments (90), antihypertensive medications (80) and unstable angina (75).<h4>Conclusions</h4>Recent trends in CHD mortality mainly reflected increases in major modifiable risk factors, notably SBP and cholesterol, BMI and diabetes. Current prevention strategies are mainly focused on treatments but should become more comprehensive. |
| format | Article |
| id | doaj-art-3cc40aa180cf4ab6a6b1780fbc7cce89 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-3cc40aa180cf4ab6a6b1780fbc7cce892025-08-20T03:09:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0185e6320210.1371/journal.pone.0063202Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009.Olfa SaidiNadia Ben MansourMartin O'FlahertySimon CapewellJulia A CritchleyHabiba Ben Romdhane<h4>Background</h4>In Tunisia, Cardiovascular Diseases are the leading causes of death (30%), 70% of those are coronary heart disease (CHD) deaths and population studies have demonstrated that major risk factor levels are increasing.<h4>Objective</h4>To explain recent CHD trends in Tunisia between 1997 and 2009.<h4>Methods</h4><h4>Data sources</h4>Published and unpublished data were identified by extensive searches, complemented with specifically designed surveys.<h4>Analysis</h4>Data were integrated and analyzed using the previously validated IMPACT CHD policy model. Data items included: (i)number of CHD patients in specific groups (including acute coronary syndromes, congestive heart failure and chronic angina)(ii) uptake of specific medical and surgical treatments, and(iii) population trends in major cardiovascular risk factors (smoking, total cholesterol, systolic blood pressure (SBP), body mass index (BMI), diabetes and physical inactivity).<h4>Results</h4>CHD mortality rates increased by 11.8% for men and 23.8% for women, resulting in 680 additional CHD deaths in 2009 compared with the 1997 baseline, after adjusting for population change. Almost all (98%) of this rise was explained by risk factor increases, though men and women differed. A large rise in total cholesterol level in men (0.73 mmol/L) generated 440 additional deaths. In women, a fall (-0.43 mmol/L), apparently avoided about 95 deaths. For SBP a rise in men (4 mmHg) generated 270 additional deaths. In women, a 2 mmHg fall avoided 65 deaths. BMI and diabetes increased substantially resulting respectively in 105 and 75 additional deaths. Increased treatment uptake prevented about 450 deaths in 2009. The most important contributions came from secondary prevention following Acute Myocardial Infarction (AMI) (95 fewer deaths), initial AMI treatments (90), antihypertensive medications (80) and unstable angina (75).<h4>Conclusions</h4>Recent trends in CHD mortality mainly reflected increases in major modifiable risk factors, notably SBP and cholesterol, BMI and diabetes. Current prevention strategies are mainly focused on treatments but should become more comprehensive.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0063202&type=printable |
| spellingShingle | Olfa Saidi Nadia Ben Mansour Martin O'Flaherty Simon Capewell Julia A Critchley Habiba Ben Romdhane Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009. PLoS ONE |
| title | Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009. |
| title_full | Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009. |
| title_fullStr | Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009. |
| title_full_unstemmed | Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009. |
| title_short | Analyzing recent coronary heart disease mortality trends in Tunisia between 1997 and 2009. |
| title_sort | analyzing recent coronary heart disease mortality trends in tunisia between 1997 and 2009 |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0063202&type=printable |
| work_keys_str_mv | AT olfasaidi analyzingrecentcoronaryheartdiseasemortalitytrendsintunisiabetween1997and2009 AT nadiabenmansour analyzingrecentcoronaryheartdiseasemortalitytrendsintunisiabetween1997and2009 AT martinoflaherty analyzingrecentcoronaryheartdiseasemortalitytrendsintunisiabetween1997and2009 AT simoncapewell analyzingrecentcoronaryheartdiseasemortalitytrendsintunisiabetween1997and2009 AT juliaacritchley analyzingrecentcoronaryheartdiseasemortalitytrendsintunisiabetween1997and2009 AT habibabenromdhane analyzingrecentcoronaryheartdiseasemortalitytrendsintunisiabetween1997and2009 |