European cardiovascular disease statistics
Abstract
This is the third edition of European cardiovascular disease statistics. The first edition was published in 2000 when the European Union (EU) consisted of 15 Member States. After enlargement in 2004 and then again in 2007, there are now 27 Member States. Much has changed in the last seven years, but cardiovascular disease (CVD) remains the main cause of death in the EU. The European cardiovascular disease statistics was the first publication to bring together all the available sources of information about the burden of CVD in Europe, including data on death and illness, treatment, the prevalence of behavioural risk factors for CVD (smoking, diet, physical inactivity and alcohol consumption), and the prevalence of medical conditions associated with CVD (raised cholesterol, raised blood pressure, overweight and obesity, and diabetes). It
has become an indispensable resource for anybody working on reducing the burden of CVD in Europe or in public health generally.<br /
... Risk factors for CVD include smoking, hypertension, obesity, and lack of physical activity [5]. Cardiac rehabilitation is associated with a reduction in both cardiac mortality (26-36%) and total mortality (13-26%) [6]. ...
Introduction
Chronic obstructive pulmonary disease (COPD) and coronary artery disease are common treatable and preventable chronic diseases. Rehabilitation is now considered an important part of the long-term management in both diseases and includes exercise, education, and smoking cessation.
Patients and methods
This study included 40 patients with COPD and coronary artery disease referred to the cardiac rehabilitation unit at Ain Shams University hospitals. Patients were assessed by clinical assessment, ECG, ECHO, modified Bruce protocol, spirometry, and St George’s Respiratory Questionnaire (SGRQ). Then, patients were divided into two groups: a cardiac rehabilitation group and a cardiopulmonary rehabilitation group. All patients received 8–12 weeks of rehabilitation and were reassessed by spirometry, the modified Bruce protocol, and SGRQ.
Results
Both groups improved in terms of spirometric parameters (forced expiratory volume in 1 s and forced expiratory volume in 1 s/forced vital capacity), SGRQ, and metabolic equivalents of tasks, but there was a statistically significant in resting heart rate in the cardiopulmonary rehabilitation group.
Conclusion
The inclusion of upper limb exercise and inspiratory muscles training in pulmonary rehabilitation improves exercise tolerance in patients suffering from both COPD and coronary artery disease compared with cardiac rehabilitation alone.
... Rate of death with cardiovascular diseases (CVD) was found higher in women in this phase of life than men. 5 A number of studies have reported that women between age 40-49 i.e. at the time of the menopause transition or perimenopausal period, had significantly greater risk of mortality. 6,7 Peri-menopausal/postmenopausal women had generally higher lipid level. 3,4,8 It is suggested that the ovarian function i.e. reduced production of estrogen might be one of the causative factors for the development of cardiovascular diseases in this period of life in female. ...
Background : One of risk factors for increased rate of cardiovascular diseases and development of menopausal symptoms in perimenopausal/postmenopausal women is reduced estrogen production. Yoga practice improved menopausal symptoms in postmenopausal women. Whether yoga practice had effect on estrogen in perinomopausal/postmenopausal women was not known. Thus, this study was conducted to assess the effect of yoga on female hormones; estrogen, progesterone, luteinizing hormone (LH), and follicular stimulating hormone (FSH) in perimenopausal women. Methods : The study included 60 perimenopausal women, grouped into yoga (n=30, age 44±2.64 years) and control (n=30, age 46±5.09 years) groups. The yoga group practiced meditation, pranayama and few simple asanas for 40 min/day, 6 days/week for 4 weeks. The control group did not practice any kinds of exercise. Levels of female hormones were assessed in all subjects at the beginning of the study and after four weeks of the study, and compared statistically. Institutional Ethical Committee approved the study. Results : Age, body mass index (BMI), blood pressure (BP), Heart rate (HR), and respiratory rate were comparable between the groups at the beginning of the study. Hormones LH and FSH showed no significant changes within and between group comparisons. Serum estrogen [11.95 (5.05-41.32) vs 24.47 (12.54-64.90) pg/ml, p=0.036] and progesterone [0.24 (0.10-1.02) vs 2.0 (0.25-9.73) ng/ml, p=0.012] increased in yoga group after yoga practice in within group comparisons, whereas, the control group showed no changes. Conclusion : Estrogen and progesterone levels increased in perimenopausal women after four weeks of yoga practice, whereas, LH and FSH showed no changes. It reveals that yoga practice can have cardio protective effects in perimenopausal women.
... These figures are much the same as those in osteoarthritis/rheumatoid arthritis research from 2015 [3]. Data from the Eurostat indicate the same effect: diseases of the circulatory system are the main cause of death in the EU, responsible for almost 37% of all deaths in 2017 [4,5]. Earle et al. recently presented data on the cause of death in patients with risk of pulmonary embolism (PE), and their figures were basically in correspondence [6]. ...
Many assets of clinical medicine, such as clinical chemistry and diagnostic imaging, make clinical diagnosis outstanding compared to postmortem diagnosis. An assessment of functional status certainly has priority over the postmortem, cross-sectional use of diagnostic tests and laboratory equipment. In addition, the cost of these tools is sometimes steep, and their use does not always fit into a reasonable cost-benefit ratio. However, sometimes postmor-tem observations, such as inflammation, pulmonary edema, or infiltration and cerebral swelling, cannot be explained without implementing immunohistochemical markers for postmortem diagnosis. Introducing blood-based bi-omarkers in postmortem care could significantly reduce the rates of inconclusive postmortems and discrepancies in autopsy findings and clinical diagnoses. This is particularly relevant in the scope of vascular pathology, considering the great burden of vascular diseases in overall mortality. Expanding traditional autopsy with blood-based (circulat-ing) biomarkers to avoid invasive postmortem examination would have cultural, religious, and potential economic advantages. All of the target molecules are discussed in the context of the process they up-regulate or down-regulate and which turns out to be the final cause of death. Ultimately, it is evident that further studies are needed to provide concrete validation for a combination of markers on a specific case order to reach a postmortem diagnosis with or without clinical records.
Deep learning (DL) approaches provide predictive analysis capabilities for heart-related diseases (HRD), enabling early pattern detection and identification of associated risk factors. Additionally, nature-inspired algorithms have demonstrated their efficacy in optimizing complex problems, including risk prediction, treatment planning, and resource allocation in disease management. Therefore, this paper proposes a hybrid approach that combines DL methods with a nature-inspired algorithm. In this paper, the Crow Search Optimization Algorithm (CSOA) is integrated with DL techniques for HRD classification. The classification was performed using deep neural network (DNN) and convolutional neural network (CNN) algorithms. The experiments were conducted on two datasets: the Cardio dataset, containing numeric HRD data, and the NIH chest X-ray image dataset, comprising HRD-related X-ray images. Several optimizers, such as Stochastic Gradient Descent with Momentum, RMSProp, Adam, Adagrad, Follow the Regularized Leader, and Nadam, were evaluated for the classification task. Importantly, the combination of CSOA with DNN (CSOA-DNN) significantly enhances the performance of the DNN model on the Cardio dataset. Overall, the Adam and Nadam optimizers consistently outperform other optimizers across various performance parameters during both training and validation. Using the Adam optimizer, the classification accuracy reaches 96.6% (trained AR) and 92.2% (validation AR), with precision (PS) at 91%, recall (RL) at 95.5%, and F-score (FS) at 93.2%. Similarly, the Nadam optimizer achieves comparable results, with accuracy at 96.5% (trained AR) and 93.3% (validation AR), precision at 91.7%, recall at 95.7%, and F-score at 93.7%. These findings underscore the superior performance of the Adam and Nadam optimizers across various performance parameters in both DNN and CNN models. The incorporation of CSOA notably enhances the performance of the DNN model, leading to improved classification accuracy and other performance measures.
Introduction . Basing on the data of the “RACSMI-UZ” register, the article provides comparative analysis of the structure and transformation of diagnoses during acute coronary conditions in the dynamics (at admission and discharge), assesses patients' adherence to drug therapy depending on gender and also describes analysis of its effect on the short-term prognosis.
Material and methods. The study material included 449 patients with ACS/AMI hospitalized to relevant health care facilities of the experimental district of Tashkent. Two groups of patients were distinguished depending on the gender: group 1 included 243 male patients, and group 2 consisted of 206 female patients.
Results. The registration showed that ACS/AMI was more often observed in men than in women (54.1% vs. 45.9%, respectively). Male patients proved to be younger than female ones (p <0.05); obesity of different degree prevailed in women (48.0% in women vs. 29.6% in men, p <0.05). In the male population, AMI at admission was registered in 43 (17.7%) patients but the number of patients with this diagnosis increased at discharge (61 subjects, or 25.1%). Out of 243 men, 3.7% died and the largest number of deaths occurred in patients with initial diagnosis of unstable angina. In the female population, the incidence of AMI both with and without Q at admission was recorded 2 times less frequent than that at discharge from the hospital (8.7% of cases at admission and 17.5% of cases at discharge), which shows low vigilance of healthcare professionals in diagnostics of AMI in women. Mortality from ACS/ AMI in women was 3.4% with the largest number of deaths being associated with the initial diagnosis of AMI without Q. Compliance in females was somewhat higher than in males; men were prone to taking more medications (Mc’s), though there were no significant differences between men and women by the proportion of Mc’s taken. The direct correlation was found between the patients’ compliance level and the time interval: from admission to death of the respondent (p> 0.05).
Conclusion. ACS / AMI was more often recorded in men than in women, while the age of men was younger (p<0.05). Alertness of primary care physicians in ACS / AMI was low, especially for women. Compliance in women was higher than in men. Thus, the higher was the patient adherence to therapy, the more stable the body appeared to cardio stress.
The cardiovascular disorders are increasing day by day. Coronary artery disease (CAD) is currently a leading cause of death worldwide. Drug-eluting stents (DESs) have been dominant for the treatment of CAD in the interventional cardiology world owing to their efficacy in significantly reducing restenosis as compare to metallic stents. However, late stage stent thrombosis has become a major concern. Stent platform, drug delivery vehicle and types of drugs are three parts of DES and each part affects the performance of the DES. This review gives real answer about safety control of restenosis and thrombosis in CAD by using drug eluting stent.
Many tools of clinical medicine, such as clinical chemistry and diagnostic imaging, are prioritized for clinical diagnosis over post mortem diagnosis. Indeed, it is reasonable that the assessment of a patient’s functional status should take priority over the post mortem, cross-sectional use of diagnostic tests and laboratory equipment. In addition, these tools are sometimes expensive, and their use does not always have a reasonable cost–benefit ratio. However, some post mortem observations, such as inflammation, pulmonary edema, or infiltration and cerebral swelling, cannot be explained without using immunohistochemical markers for post mortem diagnosis. Introducing blood-based biomarkers into post mortem care could significantly reduce the rates of inconclusive post mortems and discrepancies in autopsy findings and clinical diagnoses. This is particularly relevant in relation to vascular pathology, considering the significant burden that vascular diseases represent for overall mortality. Expanding traditional autopsies with blood-based (circulating) biomarkers to avoid invasive post mortem examination would have cultural, religious, and potentially economic advantages. All of the target molecules were discussed in the context of the processes they up-regulate or down-regulate, which turned out to be the final cause of death. Ultimately, it is evident that further studies are needed to provide concrete validation for using a combination of markers for each case to reach a post mortem diagnosis with or without clinical records.
Background: The objective of this systematic review and meta-analysis was: (i) to examine the association between wine consumption and cardiovascular mortality, cardiovascular disease (CVD), and coronary heart disease (CHD) and (ii) to analyse whether this association could be influenced by personal and study factors, including the participants’ mean age, the percentage of female subjects, follow-up time and percentage of current smokers. Methods: In order to conduct this systematic review and meta-analysis, we searched several databases for longitudinal studies from their inception to March 2023. This study was previously registered with PROSPERO (CRD42021293568). Results: This systematic review included 25 studies, of which the meta-analysis included 22 studies. The pooled RR for the association of wine consumption and the risk of CHD using the DerSimonian and Laird approach was 0.76 (95% CIs: 0.69, 0.84), for the risk of CVD was 0.83 (95% CIs: 0.70, 0.98), and for the risk of cardiovascular mortality was 0.73 (95% CIs: 0.59, 0.90). Conclusions: This research revealed that wine consumption has an inverse relationship to cardiovascular mortality, CVD, and CHD. Age, the proportion of women in the samples, and follow-up time did not influence this association. Interpreting these findings with prudence was necessary because increasing wine intake might be harmful to individuals who are vulnerable to alcohol because of age, medication, or their pathologies.
In this study, changes in heart-type fatty acid binding protein (H-FABP) and certain biochemical parameters during chronic artery diseases were investigated. Coronary artery disease (CAD) is one of the leading causes of death and morbidity in our country,which is also true for the world in general as well. CAD generally develops on the foundations of atherosclerosis. In this study, blood samples collected from patients who applied to Van Yüzüncü Yıl University Dursun Odabaş Medical Center Emergency Department and Cardiology Polyclinics with acute ischemic chest pain between January 2019 and June 2019 were evaluated. Patients were not given any drugs or other kinds of substances before sample collection. Of the patients who applied to the cardiology clinic, 24 patients with acute ischemic chest pain were diagnosed with chronic arteritis, 12 patients with cardiological problems were diagnosed with diabetes mellitus (DM), 12 patients with hypertension (HT) problems and heart complaints, and 12 healthy individuals (who were not diagnosed with diabetes, hypertension or CAD) were included as research materials. Certain markers like Troponin, CK, CK-MB, AST, ALT, LDL-Cholesterol, HDL-Cholesterol, LDH, Glucose, and Creatinine in the blood samples were biochemically determined using an autoanalyzer (Abbott ci16200),while H-FABP values were determined using ELISA method. LDL-cholesterol levels were highest in the CAD group, HDL-Cholesterol and LDH levels were high in the CAD+HT group, while CK, CK-MB, cTnI, AST, Glucose, creatinine, and H-FABP levels were found to be high in the DM+CADgroup. Meanwhile, cTnI values were increased in people with HT or DM in addition to CAD, but there was no statistical significance. LDL-cholesterol changes also did not vary significantly between the groups. Intergroup changes in other parameters examined showed the importance of CK and Glucose levels at p≤ 0.001, AST p≤ 0.002, LDH p≤ 0.003, CK-MB p≤ 0.004, HDL-Cholesterol p≤ 0.049, Creatinine p≤ 0.011, and H-FABP p≤ 0.050. In recent years, H-FABP has taken its place in the field of cardiology with increasing importance in the diagnosis of CAD and MI. The findings obtained in this study show that the H-FABP level was increased in all patients examined (except the test group), and we recommend its use as a critical and useful parameter in the field of cardiology.
In the last 35 years Poland has undergone a series of fundamental economic, social, and biological transformations. With the transition from a centrally planned to a free-market economy, a period of economic and social transformation, Poland’s accession to the European Union, and the COVID-19 coronavirus pandemic, living conditions in the country have seen dramatic changes. The aim of this study was to assess whether there were changes in the basic health behaviors of Polish women, and if so, in what directions and with what strength, and whether there were differences in these changes depending on the socioeconomic status. Information on basic lifestyle factors (drinking alcohol, smoking, coffee drinking, and physical activity) and socioeconomic status (level of education, Gini coefficient, Gender Inequality Index, women total employment, employed women being in managerial positions, women among scientists) of 5806 women aged 40–50 years were analyzed. During the 1986–2021 period, based on the same methodology, team of technicians and research tools, six birth cohorts of women were examined in 1986, 1991, 1996, 2006, 2019 and 2021. Highly statistically significant changes were found in the frequencies of declared health behaviors from 1986–2021, according to the order of significance in coffee and alcohol consumption, physical activity levels, and smoking and smoking intensity. In subsequent cohorts, there were fewer and fewer women who did not drink coffee and alcohol, while more drank more than two cups of coffee a day and drank alcohol more often than 2× a week. Furthermore, they were more likely to be physically active, and slightly fewer were smokers. The lifestyles of the women were less likely to depend on their socio-economic status than the cohorts. In 1991 and 1996, there was a marked intensification of unhealthy behavior. Changes in the analyzed health behaviors may have been caused by adaptation to the high level of psychosocial stress observed during the transition of the 1986–2021 period and may result in changes in the biological condition and quality and length of life of Polish women. Research on social differences in health behavior provides an opportunity to analyze the biological effects of changes in the living environment.
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