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Female Head, Food Stamps, Ethnicity and Air Pollution: Confounders or Causes of Heart Disease in Texas  [PDF]
Faye Anderson, Najla N. Al-Thani
Open Journal of Epidemiology (OJEpi) , 2016, DOI: 10.4236/ojepi.2016.62015
Abstract: One in every four deaths in the United States is attributed to heart disease. While the ethnic variations have not been momentous, the socioeconomic disparities of heart disease incidence need to be further investigated. Moreover, exposure to air pollutants has been documented to cause heart disease. This secondary-data study investigates the effects of air pollutants as well as socioeconomic factors on hospitalization rate of heart disease in Texas. The rates for the five sub-diagnoses of cardiovascular disease, heart attack, stroke, hypertension and heart disease were linked to ozone, fine particulate matter, carbon monoxide, nitrogen dioxide, sulphur dioxide and socioeconomic status factors at the county level. These were college education attainment, households with female heads, percentage of users of food stamps, ethnicities, living near a park and living in houses with severe housing problems. Spatial lag modelling was conducted to estimate the statistical significance of the independent variables on the five sub-diagnoses of heart disease. Fine particulate matter, sulphur dioxide and being African American were significant to all the outcomes. Living in a household with female head was significant to stroke and hypertension. Using food stamps was significant to cardiovascular disease, heart attack and heart disease. Fine particulate matter and sulphur dioxide increase the risk of heart disease by a factor of three to twenty two times, respectively. Whereas low socioeconomic status increases the risk of heart disease by a factor of up to four times. The results of the effect of particulate air and sulphur dioxide pollution among people in low social class especially African Americans. The vicious cycle of heart disease and low socioeconomic status call for societal and policy makers’ attention through methodical interventions to address the two significant issues of industrial facilities site allocation and stationary emission resources.
Study on Heart Attack with Special Reference to Hypertension In People of Faisalabad  [PDF]
Mehnaz Afzal,M. Tariq Javed,Kausar Almas,Tahir Zahoor
Journal of Medical Sciences , 2001,
Abstract: A total of 200 patients were selected and were divided into five age groups (<40, 40-50, 51-60, 61-70 and > 70 Years), two socioeconomic status, i.e., low and middle class, and gender. Results revealed that patients admitted with heart attack, 63.5 % were having hypertension and there found an association between hypertension and family history of heart attack. The occurrence of heart attack in both hypertensive and non-hypertensive group was more in males than females and was higher in peoples of more than 41 years of age. Data also showed that occurrence of heart attack due to hypertension was high in people belonging to cities than villages. Data did not reveal difference between hypertensive and non-hypertensive patients with respect to tea intake and cigarette smoking. Serum cholesterol was higher (P<0.05) in hypertensive than non-hypertensive patients taking 6-10 cigarette dayG1. Serum triglyceride levels were higher (P<0.05) in hypertensive than non-hypertensive males. Serum HDL was higher in patients used oil than those used ghee. Serum uric acid appeared to have relation with beef intake as the levels were higher in beef eaters in both hypertensive and non-hypertensive patients.
Socioeconomic Status and Coronary Heart Disease
Ali Janati,Hossein Matlabi,Hamid Allahverdipour,Masumeh Gholizadeh
Health Promotion Perspectives , 2011, DOI: 10.5681/hpp.2011.011
Abstract: Background: Iran has undergone a remarkable demographic transition over the last threedecades. Socioeconomic status (SES) indicators including education, income, and occupationare associated with coronary heart disease (CHD) risk factors, morbidity, and mortality. Theaim of the present study was to describe demographic and socioeconomic characteristics, theirassociation to the diseases, and to explore the predictive risk of CHD in Tabriz, the fourthlargest city in Iran and the capital of East Azerbaijan Province.Methods: This cross-sectional descriptive study was carried out to explore and analyze thecurrent SES status of CHD patients. The study was conducted in Tabriz and all patients(n=189) refereed to the Central Referral Hospital for cardiac patients (Shahid Madani Hospital)from 2009 to 2010 were considered. A researcher structured questionnaire with 15 questionswas used to collect data. Descriptive statistics were used to describe the basic SES featuresof the CHD patients and data analysis was done using SPSS ver. 16.Results: Less educated participants were more susceptible to CHD. Regarding to occupationalstatus, housewives and retired men were in higher risk of CHD than the rest of the people.Studied patients also reported to be mostly from urban areas that were living in apartmentcomplexes.Conclusion: In line with some international research evidence the study results suggested thatpeople from lower/middle social classes were in greater CHD risk than higher social classes.This epidemic might be halted through the promotion of healthier lifestyles and the support ofenvironmental and policy changes.
A Cost Evaluation of the Georgia Stroke and Heart Attack Prevention Program  [cached]
David B. Rein, PhD,Roberta T. Constantine, PhD,Diane Orenstein, PhD,Hong Chen, MS
Preventing Chronic Disease , 2006,
Abstract: IntroductionHypertension is a leading cause of stroke, coronary artery disease, heart attack, and heart and kidney failure in the United States, all of which contribute to the rising costs of health care. The Georgia Stroke and Heart Attack Prevention Program is an education and direct service program for low-income patients with hypertension. This project evaluated the cost-effectiveness of the program compared with the following two alternative scenarios: no treatment for high blood pressure and the typical hypertension treatment received in the private sector nationwide (usual care).MethodsWe estimated the preventive treatment costs and number of adverse health events averted (hemorrhagic and ischemic stroke, heart disease, and kidney failure) associated with the Georgia Stroke and Heart Attack Prevention Program in two Georgia health districts. We used program cost and service usage data obtained from the Georgia Department of Human Resources and probabilities and costs of expected adverse events published in peer-reviewed sources. We compared program costs and number of expected adverse health events averted with those expected from 1) no preventive care and 2) usual care for high blood pressure.ResultsThe Georgia Stroke and Heart Attack Prevention Program was less costly and resulted in better health outcomes than either no preventive care or usual care. Compared with no preventive care in the two districts, the program was estimated to result in 54% fewer expected adverse events; compared with usual care, the program was estimated to result in 46% fewer expected adverse events. Combining the costs of preventive treatment with the costs of expected adverse events, the Georgia Stroke and Heart Attack Prevention Program cost an average of $486 per patient annually, compared with average annual costs of $534 for no care and $624 for usual care.ConclusionMaintaining a publicly financed stroke and heart attack prevention program is more cost-effective and results in greater health benefits than other plausible scenarios. Because the benefits of this program accrue to both the state and federal governments through reduced Medicaid and indigent care expenditures, both the state and federal governments have a financial incentive to support the program.
Socioeconomic and Environmental Risk Factors among Rheumatic Heart Disease Patients in Uganda  [PDF]
Emmy Okello, Barbara Kakande, Elias Sebatta, James Kayima, Monica Kuteesa, Boniface Mutatina, Wilson Nyakoojo, Peter Lwabi, Charles K. Mondo, Richard Odoi-Adome, Freers Juergen
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0043917
Abstract: Background Although low socioeconomic status, and environmental factors are known risk factors for rheumatic heart disease in other societies, risk factors for rheumatic heart disease remain less well described in Uganda. Aims and Objective The objective of this study was to investigate the role of socio-economic and environmental factors in the pathogenesis of rheumatic heart disease in Ugandan patients. Methods This was a case control study in which rheumatic heart disease cases and normal controls aged 5–60 years were recruited and investigated for socioeconomic and environmental risk factors such as income status, employment status, distance from the nearest health centre, number of people per house and space area per person. Results 486 participants (243 cases and 243 controls) took part in the study. Average age was 32.37+/?14.6 years for cases and 35.75+/?12.6 years for controls. At univariate level, Cases tended to be more overcrowded than controls; 8.0+/?3.0 versus 6.0+/?3.0 persons per house. Controls were better spaced at 25.2 square feet versus 16.9 for cases. More controls than cases were employed; 45.3% versus 21.1%. Controls lived closer to health centers than the cases; 4.8+/?3.8 versus 3.3+/?12.9 kilometers. At multivariate level, the odds of rheumatic heart disease was 1.7 times higher for unemployment status (OR = 1.7, 95% CI = 1.05–8.19) and 1.3 times higher for overcrowding (OR = 1.35, 95% CI = 1.1–1.56). There was interaction between overcrowding and longer distance from the nearest health centre (OR = 1.20, 95% CI = 1.05–1.42). Conclusion The major findings of this study were that there was a trend towards increased risk of rheumatic heart disease in association with overcrowding and unemployment. There was interaction between overcrowding and distance from the nearest health center, suggesting that the effect of overcrowding on the risk of acquiring rheumatic heart disease increases with every kilometer increase from the nearest health center.
Short-Term Effects of Particulate Matter on Stroke Attack: Meta-Regression and Meta-Analyses  [PDF]
Xiao-Bo Yu, Jun-Wei Su, Xiu-Yang Li, Gao Chen
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0095682
Abstract: Background and Purpose Currently there are more and more studies on the association between short-term effects of exposure to particulate matter (PM) and the morbidity of stroke attack, but few have focused on stroke subtypes. The objective of this study is to assess the relationship between PM and stroke subtypes attack, which is uncertain now. Methods Meta-analyses, meta-regression and subgroup analyses were conducted to investigate the association between short-term effects of exposure to PM and the morbidity of different stroke subtypes from a number of epidemiologic studies (from 1997 to 2012). Results Nineteen articles were identified. Odds ratio (OR) of stroke attack associated with particular matter (“thoracic particles” [PM10]<10 μm in aerodynamic diameter, “fine particles” [PM2.5]<2.5 μm in aerodynamic diameter) increment of 10 μg/m3 was as effect size. PM10 exposure was related to an increase in risk of stroke attack (OR per 10 μg/m3 = 1.004, 95%CI: 1.001~1.008) and PM2.5 exposure was not significantly associated with stroke attack (OR per 10 μg/m3 = 0.999, 95%CI: 0.994~1.003). But when focused on stroke subtypes, PM2.5 (OR per 10 μg/m3 = 1.025; 95%CI, 1.001~1.049) and PM10 (OR per 10 μg/m3 = 1.013; 95%CI, 1.001~1.025) exposure were statistically significantly associated with an increased risk of ischemic stroke attack, while PM2.5 (all the studies showed no significant association) and PM10 (OR per 10 μg/m3 = 1.007; 95%CI, 0.992~1.022) exposure were not associated with an increased risk of hemorrhagic stroke attack. Meta-regression found study design and area were two effective covariates. Conclusion PM2.5 and PM10 had different effects on different stroke subtypes. In the future, it's worthwhile to study the effects of PM to ischemic stroke and hemorrhagic stroke, respectively.
Development of Neuro-fuzzy System for Early Prediction of Heart Attack  [cached]
Obanijesu Opeyemi,Emuoyibofarhe O. Justice
International Journal of Information Technology and Computer Science , 2012,
Abstract: This work is aimed at providing a neuro-fuzzy system for heart attack detection. Theneuro-fuzzy system was designed with eight input field and one output field. The input variables are heart rate, exercise, blood pressure, age, cholesterol, chest pain type, blood sugar and sex. The output detects the risk levels of patients which are classified into 4 different fields: very low, low, high and very high. The data set used was extracted from the database and modeled in order to make it appropriate for the training, then the initial FIS structure was generated, the network was trained with the set of training data after which it was tested and validated with the set of testing data. The output of the system was designed in a way that the patient can use it personally. The patient just need to supply some values which serve as input to the system and based on the values supplied the system will be able to predict the risk level of the patient.
Knowledge of “Heart Attack” Symptoms in a Canadian Urban Community
Pamela A. Ratner,Joy L. Johnson,Martha Mackay,Andrew W. Tu
Clinical Medicine : Cardiology , 2008,
Abstract: Background: Temporal delays in myocardial infarction (MI) treatment have been addressed through patient and physician education, innovations in prehospital fibrinolysis, and improvements to emergency medical services, yet the most significant contributor to delayed treatment is the patient’s ability to recognize and respond to symptoms.Purpose: To determine whether public health education campaigns have achieved their desired reach by ensuring that all segments of the population recognize the symptoms of MI (“heart attack”).Methods: 976 men and women, 40+ years of age, randomly selected from Metro Vancouver, Canada completed a telephone survey in English, Punjabi, Mandarin, or Cantonese. Respondents’ knowledge of MI symptoms was assessed; 10 “correct symptoms” were considered to be: chest pain/pressure/tightness/discomfort, arm pain, shortness of breath, nausea/indigestion, sweating/clamminess, shoulder/back pain, dizziness/faintness/light headedness, jaw pain, weakness, and uneasiness/panic/anxiety.Results: 3.2% of the sample could not identify any correct symptoms and 53.3% were able to describe 3+ symptoms. Significant associations were found between the number of correct symptoms and gender, ethnicity, education, exposure to health professional counseling, and worry about having a heart attack. The least number of correct symptoms were reported by: men (incidence rate ratio (IRR) = 0.87; 95% confidence interval (95% CI): 0.81 0.95), Chinese-Canadian participants (IRR = 0.73; 95% CI: 0.65 0.83; relative to European-Canadian born participants), those with less than high school education (IRR = 0.78; 95% CI: 0.66 0.92; relative to those with more than high school), those with no health professional counseling (IRR = 0.92; 95% CI: 0.84 1.00), and those who did not worry “at all” about having a heart attack (IRR = 0.89; 95% CI: 0.80 0.98; relative to those who worried sometimes/often/almost all the time).Conclusions: The participants were not well informed about the symptoms of heart attack. It will be challenging to educate the public sufficiently to reduce the time between the onset of symptoms and initiation of treatment for MI.
Increasing Employee Awareness of the Signs and Symptoms of Heart Attack and the Need to Use 911 in a State Health Department  [cached]
Crystelle C. Fogle,Carrie S. Oser,Lynda L. Blades,Todd S. Harwell
Preventing Chronic Disease , 2004,
Abstract: Introduction Early recognition of the signs and symptoms of a heart attack can lead to reduced morbidity and mortality. Methods A workplace intervention was conducted among 523 Montana state health department employees in 2003 to increase awareness of the signs and symptoms of heart attack and the need to use 911. All employees received an Act in Time to Heart Attack Signs brochure and wallet card with their paychecks. Act in Time posters were placed in key workplace areas. A weekly e-mail message, including a contest entry opportunity addressing the signs and symptoms of heart attack, was sent to all employees. Baseline and follow-up telephone surveys were conducted to evaluate intervention effectiveness. Results Awareness of heart attack signs and symptoms and the need to call 911 increased significantly among employees from baseline to follow-up: pain or discomfort in the jaw, neck, or back (awareness increased from 69% to 91%); feeling weak, light-headed, or faint (awareness increased from 79% to 89%); call 911 if someone is having a heart attack or stroke (awareness increased from 84% to 90%). Awareness of chest pain, pain or discomfort in the arms or shoulders, and shortness of breath were more than 90% at baseline and did not increase significantly at follow-up. At baseline, 69% of respondents correctly reported five or more of the signs and symptoms of heart attack; 89% reported correctly at follow-up. Conclusion This low-cost workplace intervention increased awareness of the signs and symptoms of heart attack and the need to call 911.
State level correlations between high heart attack and stroke symptomology knowledge scores and CVD risk factors and mortality rates  [PDF]
Mary Nawal Lutfiyya, Krista L. Huot, Maria L. Amaro, Michael F. Akers, Michael Swanoski
Health (Health) , 2013, DOI: 10.4236/health.2013.510220

Introduction: In 2008, cardiovascular disease (CVD) accounted for one in three deaths in the United States. Epidemiological analyses suggest that two or more risk factors are the indicator of high risk and/or poor CVD outcomes. Knowledge of heart attack and stroke symptomology has been the focus of much research based on the assumption that accurate identification of an event is critical to reducing time to treatment. There is a paucity of research showing a clear association between knowledge of heart attack and stroke symptomology, risk factors, and mortality rates. In this study, we hypothesized that high stroke and heart attack symptomology knowledge scores would correspond to lower stroke or CVD mortality rankings as well as to a lower prevalence of two or more CVD risk factors. Methods: State was the unit of analysis used to examine data from two different sources and combined into a customized database. The first source was a multiyear Behavioral Risk Factor Surveillance Survey (BRFSS) heart attack and stroke symptom knowledge module database. CVD and stroke mortality data used came from the American Heart Association’s (AHA) 2012 Heart Disease and Stroke Statistics Update. Spearman’s Rho was the test statistic. Results: A moderate negative correlation was found between high heart attack and stroke symptom knowledge scores and the percentage of adults with two or more CVD or stroke risk factors. Likewise, a similar correlation resulted from the two variables, high heart attack and stroke symptoms knowledge score and CVD mortality rank. Conclusions: This study demonstrated a significant relationship between high heart attack and stroke symptom knowledge and lower CVD mortality rates and lower prevalence of two or more CVD risk factors at the state level. Our findings suggest that it is important to continue education efforts regarding heart attack and stroke symptom knowledge. Pharmacists are one group of health care providers who could enhance the needed public health education efforts.

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