Secondary prevention of cardiovascular disease in China

Abstract

ObjectiveWe aimed to estimate the current use of secondary prevention drugs and identify its associated individual characteristics among those with established cardiovascular diseases (CVDs) in the communities of China.MethodsWe studied 2 613 035 participants aged 35–75 years from 8577 communities in 31 provinces in the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, a government-funded public health programme conducted from 2014 to 2018. Participants self-reported their history of ischaemic heart disease (IHD) or ischaemic stroke (IS) and medication use in an interview. Multivariable mixed models with a logit link function and community-specific random intercepts were fitted to assess the associations of individual characteristics with the reported use of secondary prevention therapies.ResultsAmong 2 613 035 participants, 2.9% (74 830) reported a history of IHD and/or IS, among whom the reported use rate either antiplatelet drugs or statins was 34.2% (31.5% antiplatelet drugs, 11.0% statins and 8.3% both). Among the 1 530 408 population subgroups, which were defined by all possible permutations of 16 individual characteristics, reported use of secondary prevention drugs varied substantially (8.4%–60.6%). In the multivariable analysis, younger people, women, current smokers, current drinkers, people without hypertension or diabetes and those with established CVD for more than 2 years were less likely to report taking antiplatelet drugs or statins.ConclusionsThe current use of secondary prevention drugs in China is suboptimal and varies substantially across population subgroups. Our study identifies target populations for scalable, tailored interventions to improve secondary prevention of CVD.

Predictors and Outcomes of Secondary Prevention Medication in Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

“…Our results support the finding of previous work that increased disease severity and cardiovascular risk factors were associated with higher prescription rate GDPM [ 12 14 ]. Patients with STEMI or prior MI were more likely to receive GDPM.…”

“…In terms of individual drugs, our study reported higher prescription rates of aspirin, clopidogrel, statins and β-blockers than those reported in other studies [ 12 13 14 ]. In contrast, due to the underutilisation of ACEIs/ARBs, the prescription rate of secondary prevention drug combination in our study was relatively low.…”

Heartbeat: taking care of patients with cardiovascular disease during a pandemic

“…The importance of secondary CVD prevention in adults after a cardiac event is well established yet many patients fail to take appropriate medications. In order to identify individual characteristics associated with use of secondary CVD preventative medications, Lu and colleagues 4 studied the 74 830 participants with known CVD in the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, out of a total participant group of over 2.6 million people aged 35-75 years of age. The overall use of secondary prevention medications was quite low; 31 .% used antiplatelet drugs, 11% used statins and 8.3% used both medications.…”

Roles and Therapeutic Implications of Endoplasmic Reticulum Stress and Oxidative Stress in Cardiovascular Diseases

“…CVD is a common multifactorial disease [ 17 , 18 ]. CVD including hypertension, pulmonary hypertension, myocardial infarction and stroke is mainly caused by atherosclerosis; obesity and diabetes are major risk factors [ 19 , 20 ]. Studies have demonstrated that ER stress and oxidative stress play roles in the pathogenesis of these cardio-metabolic diseases.…”