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PURE trial - Summary & Results
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PURE trial - Summary & Results

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http://www.theheart.org/web_slides/1283911.do …

http://www.theheart.org/web_slides/1283911.do

A survey of 153,996 adults on prospective urban rural epidemiology (PURE) to examine the relationship of societal influences on human lifestyle behaviors, CV risk factors, and incidence of chronic non communicable diseases

Published in: Health & Medicine, Technology

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  • 1. PURE (Prospective Urban RuralEpidemiology)
  • 2. PURE (Prospective Urban Rural Epidemiology)S Yusuf (McMaster University, Hamilton, ON)European Society of Cardiology 2011 Congress• A survey of 153 996 adults to examine the relationship of societal influences on human lifestyle behaviors, CV risk factors, and incidence of chronic noncommunicable diseases• Time period: 2003–2009• Population categories: Urban and rural communities in countries categorized as high-income (Canada, Sweden, and United Arab Emirates), upper-middle-income (Argentina, Brazil, Chile, Malaysia, Poland, South Africa, and Turkey), lower- middle-income (China, Colombia, and Iran), and low-income (Bangladesh, India, Pakistan, and Zimbabwe)• Analyzed the use of antiplatelets, beta blockers, ACE inhibitors or ARBs, statins, and other agents among persons with CHD or strokeACE=angiotensin-converting enzyme; ARB=angiotensin receptor blocker; CHD=coronary heartdisease
  • 3. PURE: Results (by economic status)CV drug use for secondary prevention among patients with CHD orstroke, by nation economic statusCV drug category High-income (%) Upper-middle Lower-middle Low-income Overall income (%) income (%) (%)Antiplatelets 62.0 24.6 21.9 8.8 25.3Beta blockers 40.0 25.4 10.2 9.7 17.4ACE inhibitors or ARBs 49.8 30.0 11.1 5.2 19.5BP-lowering agents 73.8 48.4 37.4 19.2 41.8Statins 66.5 17.6 4.3 3.3 14.6All decreasing trends from higher- to lower-income, p<0.0001
  • 4. PURE: Results (urban vs rural)CV drug use for secondary prevention among patients with CHD orstroke, urban vs rural populations across all surveyed countriesCV drug category Urban (%) Rural (%)Antiplatelets 27.7 21.5Beta blockers 20.3 13.1ACE inhibitors or ARBs 22.3 15.4BP-lowering agents 47.1 33.7Statins 17.2 10.6All differences urban vs rural, p<0.001
  • 5. PURE: Commentary*"These are the cheapest, the safest, and the most effective drugs. And yet we havea collective global failure." - Dr Salim Yusuf"A real improvement in global cardiovascular health could likely be obtained throughpreventive strategies focused on the well-known risk factors, including lifestylechanges." - Dr Aldo Pietro Maggioni*All comments from PURE: CV drugs underused in poor nations, rural populations(http://www.theheart.org/article/1268617.do)
  • 6. Become a member of http://www.theheart.org Become a fan on Facebook: http://www.facebook.com/theheartorg Follow us on Twitter: http://www.twitter.com/theheartorgtheheart.org is the leading online source of independent cardiology news.We are the top provider of news and opinions for over 100 000 physicians.

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