Background Ischemic heart disease(IHD) represents the most significant disease burden among all cardiovascular diseases(CVDs). The increasing prevalence of metabolic risks in the 21st century has a profound impact on ...Background Ischemic heart disease(IHD) represents the most significant disease burden among all cardiovascular diseases(CVDs). The increasing prevalence of metabolic risks in the 21st century has a profound impact on the disease burden associated with IHD. We analyzed the global, regional, and national burdens of IHD attributable to metabolic risks from 1990 to 2021.Methods The data were taken from Global Burden of Disease(GBD) study 2021. Deaths, disability-adjusted life years(DALYs),the average annual percent change(AAPC), age-standardized death rates per 100,000 persons(ASDR) and age-standardized rate per 100,000 persons(ASR) of DALYs ranging from 1990 to 2021, were extracted and stratified according to region, nationality, socio-demographic index(SDI), sex, and age. Additionally, the global future trends were predicted using Nordpred prediction model.Results Compared to 1990, in 2021, the number of death and DALYs from metabolic risk-attributed IHD increased globally by67.35% and 59.91%, respectively;whereas ASDR and ASR of DALYs showed a decreasing trend and the most severe impact was observed in male and elderly populations. In addition, the burden of disease showed an inverted V-shaped relationship with SDI from 1990 to 2021. AAPC showed a significant increase in developing countries and a decrease in developed countries. We also analyzed the effects of different risk factors including metabolic risk factors on IHD in different SDI regions and genders. The prediction of future disease burden showed that the number of death and DALYs will keep rising, while ASDR and ASR of DALYs will maintain a certain downward trend.Conclusions The results of this study highlighted the need for screening and intervention for metabolic risk factors in specific regions and populations, this should call for increased collaboration between developing and developed countries to reduce the burden of disease and improve the prognosis of patients with IHD.展开更多
Background and objective The WHO emphasises the importance of integrating advice on physical activity(PA)into primary care of patients with chronic ischaemic heart disease(IHD).Similarly,the German treatment guideline...Background and objective The WHO emphasises the importance of integrating advice on physical activity(PA)into primary care of patients with chronic ischaemic heart disease(IHD).Similarly,the German treatment guideline‘Chronic Coronary Heart Disease’recommends that general practitioners(GPs)provide advice on PA to IHD patients.However,the provision of PA advice seems to be inadequately implemented in general practice.One reason is the lack of medical training in providing PA advice effectively and efficiently.International guidelines recommend such training for health professionals.This study aims to explore experiences,perceptions and attitudes,including barriers and facilitators of GPs towards the routine delivery of PA advice to IHD patients.Methods Between March and June 2023,12 face-to-face problem-centred interviews and six focus group discussions(n=37)with GPs were conducted.Interview and discussion guides were developed and pilot tested by the multi-professional study team.We used a purposive sampling strategy,and data were collected in an iterative process.Audio-recorded data were transcribed verbatim and analysed using a content structuring procedure(deductive and inductive approach).GPs were involved throughout the entire research process,for example,in multi-professional analysis groups.Results Although GPs are mostly aware of the health benefits of PA for patients with IHD,PA advice is not routinely provided.Conversations on PA tend to be rather unstructured,and advice is often addressed more generally than customised to the patients’needs and preferences.Priority is given to other lifestyle issues,such as smoking cessation.PA advice is perceived as time-consuming and rather ineffective with regard to the target behaviour.GPs frequently express frustration in this context.GPs express a lack of and simultaneously a need for communication strategies(structure and tools)that can be integrated into everyday GP practice to motivate patients to PA.Conclusion The results provide relevant insights into the current practice of GPs with regard to their attitudes on,experiences with,and requirements for the provision of PA advice to IHD patients.These results are helpful to inform the development of appropriate GP training in the provision of very brief PA advice to IHD patients.展开更多
基金supported by the National Natural Science Foundation of China (82070055 and 82470054)the Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital, Grant No.2023LNJJ18)。
文摘Background Ischemic heart disease(IHD) represents the most significant disease burden among all cardiovascular diseases(CVDs). The increasing prevalence of metabolic risks in the 21st century has a profound impact on the disease burden associated with IHD. We analyzed the global, regional, and national burdens of IHD attributable to metabolic risks from 1990 to 2021.Methods The data were taken from Global Burden of Disease(GBD) study 2021. Deaths, disability-adjusted life years(DALYs),the average annual percent change(AAPC), age-standardized death rates per 100,000 persons(ASDR) and age-standardized rate per 100,000 persons(ASR) of DALYs ranging from 1990 to 2021, were extracted and stratified according to region, nationality, socio-demographic index(SDI), sex, and age. Additionally, the global future trends were predicted using Nordpred prediction model.Results Compared to 1990, in 2021, the number of death and DALYs from metabolic risk-attributed IHD increased globally by67.35% and 59.91%, respectively;whereas ASDR and ASR of DALYs showed a decreasing trend and the most severe impact was observed in male and elderly populations. In addition, the burden of disease showed an inverted V-shaped relationship with SDI from 1990 to 2021. AAPC showed a significant increase in developing countries and a decrease in developed countries. We also analyzed the effects of different risk factors including metabolic risk factors on IHD in different SDI regions and genders. The prediction of future disease burden showed that the number of death and DALYs will keep rising, while ASDR and ASR of DALYs will maintain a certain downward trend.Conclusions The results of this study highlighted the need for screening and intervention for metabolic risk factors in specific regions and populations, this should call for increased collaboration between developing and developed countries to reduce the burden of disease and improve the prognosis of patients with IHD.
基金funded as a junior research group in health services research by the German Ministry of Education and Research(BMBF)(funding period:05/2022-04/2027,grant number:01GY2103).
文摘Background and objective The WHO emphasises the importance of integrating advice on physical activity(PA)into primary care of patients with chronic ischaemic heart disease(IHD).Similarly,the German treatment guideline‘Chronic Coronary Heart Disease’recommends that general practitioners(GPs)provide advice on PA to IHD patients.However,the provision of PA advice seems to be inadequately implemented in general practice.One reason is the lack of medical training in providing PA advice effectively and efficiently.International guidelines recommend such training for health professionals.This study aims to explore experiences,perceptions and attitudes,including barriers and facilitators of GPs towards the routine delivery of PA advice to IHD patients.Methods Between March and June 2023,12 face-to-face problem-centred interviews and six focus group discussions(n=37)with GPs were conducted.Interview and discussion guides were developed and pilot tested by the multi-professional study team.We used a purposive sampling strategy,and data were collected in an iterative process.Audio-recorded data were transcribed verbatim and analysed using a content structuring procedure(deductive and inductive approach).GPs were involved throughout the entire research process,for example,in multi-professional analysis groups.Results Although GPs are mostly aware of the health benefits of PA for patients with IHD,PA advice is not routinely provided.Conversations on PA tend to be rather unstructured,and advice is often addressed more generally than customised to the patients’needs and preferences.Priority is given to other lifestyle issues,such as smoking cessation.PA advice is perceived as time-consuming and rather ineffective with regard to the target behaviour.GPs frequently express frustration in this context.GPs express a lack of and simultaneously a need for communication strategies(structure and tools)that can be integrated into everyday GP practice to motivate patients to PA.Conclusion The results provide relevant insights into the current practice of GPs with regard to their attitudes on,experiences with,and requirements for the provision of PA advice to IHD patients.These results are helpful to inform the development of appropriate GP training in the provision of very brief PA advice to IHD patients.
