Cardiovascular disease is a leading cause of death in Canada, accounting for over 78,000 deaths in 1998. While mortality rates have declined, it remains unclear if incidence rates have also decreased. Women experience a 10 year delay in onset compared to men but have higher rates of hospitalization and longer hospital stays. Risk factors like hypertension, high cholesterol, and diabetes disproportionately impact women's cardiovascular health. Vulnerable subgroups including low-income women and some ethnic minorities experience even greater rates of cardiovascular disease.
There has been an increase in the predominance of diabetes mellitus over the past 40 years worldwide. The worldwide occurrence of diabetes in 2000 was approximately 2.8% and is estimated to grow to 4.4% by 2030. This data interprets a projected rise of diabetes from 171 million in 2000 to well over 350 million in 2030. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. Indeed, when hypertension coexists with diabetes, the risk of CVD is increased by 75%, which further contributes to the overall morbidity and mortality of an already high risk population. Patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is associated with high prevalence of well-established risk factors such as hypertension, dyslipidaemia and obesity in these patients. Hypertension plays a major role in the development and progression of microvascular and macrovascular disease in people with diabetes. Lifestyle Modifications and pharmacotherapy are the choice for the Management of Hypertension in Patients with Diabetes.
Assessment of the Prevalence of Some Cardiovascular Risk Factors among the O...Scientific Review SR
The prevalence of some cardiovascular risk factors among the Ogonis and Ikwerres in Rivers State,
Nigeria was assessed in two hundred subjects. Well structured questionnaires were used to assess smoking status,
duration of diabetes, age, weight, and height from the participants. Measurement of blood pressure was done to
ascertain the blood pressure of the subjects. Analysis of fasting blood sugar was done to confirm diabetes s tatus of
participants. Body mass index (BMI), was calculated from the height and weight. The mean age of males in the
study was higher than that of the females (P=.05). Mean SBP and DBP values were significantly higher (P=.05)
among the Ikwerres and Ogonis. BMI was significantly higher for Ogonis than Ikwerres ( P=.05). In the various
categories of risk, BMI for males was diabetics (47.89), smokers (44.73) and hypertensives (45.37) for type III
obesity which shows a higher risk for cardiovascular disease.
Study on the Health Related Quality of Life of Patients with Ischemic strokeiosrjce
The work entitled, “Study on the health related quality of life of patients with ischemic stroke” was
conducted in the department of Neurology at a multispecialty hospital. After receiving the official approval, the
study was conducted for a period of eight months from December 2013 to August 2014. A total of 278 cases with
Neurological disorders were found, of which 117(42 %) patients were with ischemic stroke. Hypertension (59%)
and Diabetes (53%) were the major co-morbid conditions found. The Health related quality of life of the
patients was assessed by direct interviewing of individual patients with a stroke specific questionnaire. The
Health related quality of life of the patients was assessed by direct interviewing of individual patients with a
stroke specific questionnaire. Quality of life assessments are done by various methods like taking the floor and
ceiling effects of the scores, average score calculation etc. Assessment of the floor and ceiling effect showed the
potential for floor effects in the most difficult domain(strength) and the possibility of a ceiling effect in the
communication domain. Assessment of stroke severity is done by taking the mean and SD of the individual domains
What are the cardiovascular disorders?
Public Health importance
Burden of disease
Risk factors of cardiovascular disorders
Causation
Prevention strategies
Global Action Plan for the Prevention and Control of NCDs
India - National programme (NPCDCS)
There has been an increase in the predominance of diabetes mellitus over the past 40 years worldwide. The worldwide occurrence of diabetes in 2000 was approximately 2.8% and is estimated to grow to 4.4% by 2030. This data interprets a projected rise of diabetes from 171 million in 2000 to well over 350 million in 2030. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. Indeed, when hypertension coexists with diabetes, the risk of CVD is increased by 75%, which further contributes to the overall morbidity and mortality of an already high risk population. Patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is associated with high prevalence of well-established risk factors such as hypertension, dyslipidaemia and obesity in these patients. Hypertension plays a major role in the development and progression of microvascular and macrovascular disease in people with diabetes. Lifestyle Modifications and pharmacotherapy are the choice for the Management of Hypertension in Patients with Diabetes.
Assessment of the Prevalence of Some Cardiovascular Risk Factors among the O...Scientific Review SR
The prevalence of some cardiovascular risk factors among the Ogonis and Ikwerres in Rivers State,
Nigeria was assessed in two hundred subjects. Well structured questionnaires were used to assess smoking status,
duration of diabetes, age, weight, and height from the participants. Measurement of blood pressure was done to
ascertain the blood pressure of the subjects. Analysis of fasting blood sugar was done to confirm diabetes s tatus of
participants. Body mass index (BMI), was calculated from the height and weight. The mean age of males in the
study was higher than that of the females (P=.05). Mean SBP and DBP values were significantly higher (P=.05)
among the Ikwerres and Ogonis. BMI was significantly higher for Ogonis than Ikwerres ( P=.05). In the various
categories of risk, BMI for males was diabetics (47.89), smokers (44.73) and hypertensives (45.37) for type III
obesity which shows a higher risk for cardiovascular disease.
Study on the Health Related Quality of Life of Patients with Ischemic strokeiosrjce
The work entitled, “Study on the health related quality of life of patients with ischemic stroke” was
conducted in the department of Neurology at a multispecialty hospital. After receiving the official approval, the
study was conducted for a period of eight months from December 2013 to August 2014. A total of 278 cases with
Neurological disorders were found, of which 117(42 %) patients were with ischemic stroke. Hypertension (59%)
and Diabetes (53%) were the major co-morbid conditions found. The Health related quality of life of the
patients was assessed by direct interviewing of individual patients with a stroke specific questionnaire. The
Health related quality of life of the patients was assessed by direct interviewing of individual patients with a
stroke specific questionnaire. Quality of life assessments are done by various methods like taking the floor and
ceiling effects of the scores, average score calculation etc. Assessment of the floor and ceiling effect showed the
potential for floor effects in the most difficult domain(strength) and the possibility of a ceiling effect in the
communication domain. Assessment of stroke severity is done by taking the mean and SD of the individual domains
What are the cardiovascular disorders?
Public Health importance
Burden of disease
Risk factors of cardiovascular disorders
Causation
Prevention strategies
Global Action Plan for the Prevention and Control of NCDs
India - National programme (NPCDCS)
There was a time when Man was the son of nature, interacting and part of the whole process of life. Then, as his fate, man progressed, invented, produced, flourished and finally prevailed on earth. He created artificial systems in which he lived, and at times seemed so close to being protected and safe from any natural phenomenal impact. Then he realized that his own creation, byproducts, beside his aggression against his own kind were being his enemy. In recent years, disasters increased in frequency, where grade 4 or more, hurricanes attacked the southern parts of the USA, as well in Asia. Large ice bergs cracked in Greenland, North and South poles, dissolving in the sea. There is an increase or rise of the Sea level, although it is few cms a year but it became a reality
https://crimsonpublishers.com/eaes/fulltext/EAES.000501.php
For more open access journals in Crimson Publishers
Please click on link: https://crimsonpublishers.com
For More Articles on Environmental Analysis & Ecology Studies
Please click on: https://crimsonpublishers.com/eaes/
Current trends in cardiovascular assessmentAlfred Bett
This paper describe the emerging trends of assessing cardiovascular in health care setting with the aim of improving the quality of service delivery to patient. It considers the increased case of people affected by heart attack
The Use of Artificial Neural Network and Logistic Regression to Predict the I...Crimsonpublisherscojnh
The Use of Artificial Neural Network and Logistic Regression to Predict the Influence of Lifestyle on Cardiovascular Risk Factors by Jahandideh S*, Jahandideh M, Asefzadeh S and Ziaee A in COJ Nursing & Healthcare
Background; Myocardial Infarction (MI) is a term which is used for defining the necrosis in the heart muscle due to the lack of the oxygen need of myocardium which cannot be supplied by the coronaries. Aim: This study was carried out to determine the effects of some lifestyle and anthropometric parameters on some cardiac enzymes. Methods: A total of 146 students of sex, age bracket, (16 - 30) were recruited for this study. Enzymatic methods were used in the determination of AST, ALT, CKMB activities. Anthropometric measurements of the participants were taken. The result showed that there was significant increase in systolic blood pressure (SBP), weight and height (p<0.05), but there was no significant increase in their diastolic blood pressure (DBP) and body mass index (BMI) (p>0.05) in the serum ALT, AST, and CKMB activities. However, there was significant difference in ALT and AST activities (P<0.05) but there was no significant difference in serum CKMB activity (P>0.05). Statistically the percentage of the participants that had their serum ALT activity above the reference range were 16.6%, those within the reference range were 83.4%,. In serum AST activity, the percentage above the reference range were 19.9%, those within the reference range were 80.1%. Meanwhile, in serum CK-MB activity, those above the reference range were 25.2% while those within the reference range were 74.8%. Conclusion: This could be probably indicate that the leakage of AST and ALT activities may be of hepatic origin. . The non-significant increase in CKMB which is a specific marker of myocardial injury, could suggest that the subjects were not at risk of developing of myocardial infarction as regards their age.
Clinical Profile of Acute Coronary Syndrome among Young AdultsPremier Publishers
Acute Coronary Syndrome accounts for 30% of hospital admissions with cardiovascular diseases. The risk of this syndrome is increasing among the younger adults, and a deep insight into the clinical profile among these patients will help in devising a preventive strategy, in order to alleviate the morbidity and mortality due to the syndrome. A cross sectional study was done among 125 subjects admitted to our tertiary care hospital with Acute Coronary Syndrome. Their risk factors were assessed and a 12 Lead electrocardiogram and 2D Echocardiogram were taken. Cardio III panel which consists of Troponin I, CK MB, BNP by COBAS meter machine was also measured. STEMI was present in 73.6% of the patients, while unstable angina was present in 16%. About 90% of STEMI patients were males and 62% of them were hypertensives. LV Ejection Fraction <30% was found in 9% of STEMI patients. This study elucidates the need for a preventive strategy for primordial prevention of cardiovascular events among young adults. The study envisaged the male, urban preponderance towards these events.
CORONARY ARTERY DISEASE is a modern epidemic in india. due to changes in living conditions and habits its prevalence is increasing day by day . in this presentation i have explained the various risk factors and innovations in diagnosis of CAD. IT is very useful for primary health care physicians and community medicine specialist
A Study of the Prevalence of Cardio-Vascular Diseases and Its Risk Factors (B...inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
A Study on Food Habits and Social Habits as Risk Factors among Patients Under...ijtsrd
AIM A study on food habits and social habits as risk factors among patients undergoing Percutaneous Transluminal Coronary Angioplasty PTCA OBJECTIVE To know the association of food habits and social habits as risk factors for PTCA. To observe various co morbidities among the patients To study the bio chemical parameters in patients such as heamoglobin, PVC, platelet count, bilirubin levels. To observe various social habits in the patient, such as smoking and alcohol consumption. Food consumption pattern. METHODOLOGY The sample population n = 60 of 28 80 years of age were chosen from a multi speciality hospital in Hyderabad. All the patients were of different age groups, sex, socio economic status, ethnicity with different co morbidities. A pre tested format consisting of patients profile, subjective data, objective data, biochemical data, medications and 24 hour dietary recall followed by medical nutrition therapy during the hospital stay. RESULTS Among n=60 subjects from 28 80 years of age, the detailed study identified the common risk factors with respect to cardiovascular diseases. The study showed a higher percentage of age from 28 70 years and is mostly in males. Majority of the patients are with increased BMI and are alcholics smokers. Obesity, Hypertension and Diabetes are predominant and dietary patterns recorded are mostly non vegetarians with high calorie, high fat and high protein consumption. CONCLUSION From the result it is very clear that majority of the patients studied with cardiovascular diseases belong to the age group 28 70 years and is mostly seen in males. Majority of them are accompanied with co morbidities with obesity, hypertension and diabetic. And predominantly follow a high calorie and high fat diet .Thus leading to a conclusion that consumption of high calorie and high fat food, presence of co morbidities and smoking could be the risk factors of PTCA. Mrs. Meena Kumari | Mrs. Y. V. Phani Kumari | Gwyneth Madhulika Bashapaga | Ittamala Jaya Rachel ""A Study on Food Habits and Social Habits as Risk Factors among Patients Undergoing Percatenous Transluminal Coronary Angioplasty (PTCA)"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-3 , April 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23372.pdf
Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/23372/a-study-on-food-habits-and-social-habits-as-risk-factors-among-patients-undergoing-percatenous-transluminal-coronary-angioplasty-ptca/mrs-meena-kumari
Heart disease describes a variety of conditions that affect the coronary heart. Diseases underneath the coronary heart sickness umbrella consist of blood vessel diseases, together with coronary artery disorder, heart rhythm problems arrhythmias and heart defects, human beings are born with congenital heart defects , among others. If the heart disorder isnt recognized at an early stage, the patient's situation might get worsened and for that reason endanger his life. Therefore, this software program is evolved in order to research the patient check details and give an evaluation as to whether or not the affected person is healthful or requires remedy for heart disorder by giving the intensity of patient's heart situation because the result. Prof. Vikrant Chole | Karishma V. Bagde "Heart Disease Analysis System" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd31070.pdf Paper Url :https://www.ijtsrd.com/engineering/other/31070/heart-disease-analysis-system/prof-vikrant-chole
There was a time when Man was the son of nature, interacting and part of the whole process of life. Then, as his fate, man progressed, invented, produced, flourished and finally prevailed on earth. He created artificial systems in which he lived, and at times seemed so close to being protected and safe from any natural phenomenal impact. Then he realized that his own creation, byproducts, beside his aggression against his own kind were being his enemy. In recent years, disasters increased in frequency, where grade 4 or more, hurricanes attacked the southern parts of the USA, as well in Asia. Large ice bergs cracked in Greenland, North and South poles, dissolving in the sea. There is an increase or rise of the Sea level, although it is few cms a year but it became a reality
https://crimsonpublishers.com/eaes/fulltext/EAES.000501.php
For more open access journals in Crimson Publishers
Please click on link: https://crimsonpublishers.com
For More Articles on Environmental Analysis & Ecology Studies
Please click on: https://crimsonpublishers.com/eaes/
Current trends in cardiovascular assessmentAlfred Bett
This paper describe the emerging trends of assessing cardiovascular in health care setting with the aim of improving the quality of service delivery to patient. It considers the increased case of people affected by heart attack
The Use of Artificial Neural Network and Logistic Regression to Predict the I...Crimsonpublisherscojnh
The Use of Artificial Neural Network and Logistic Regression to Predict the Influence of Lifestyle on Cardiovascular Risk Factors by Jahandideh S*, Jahandideh M, Asefzadeh S and Ziaee A in COJ Nursing & Healthcare
Background; Myocardial Infarction (MI) is a term which is used for defining the necrosis in the heart muscle due to the lack of the oxygen need of myocardium which cannot be supplied by the coronaries. Aim: This study was carried out to determine the effects of some lifestyle and anthropometric parameters on some cardiac enzymes. Methods: A total of 146 students of sex, age bracket, (16 - 30) were recruited for this study. Enzymatic methods were used in the determination of AST, ALT, CKMB activities. Anthropometric measurements of the participants were taken. The result showed that there was significant increase in systolic blood pressure (SBP), weight and height (p<0.05), but there was no significant increase in their diastolic blood pressure (DBP) and body mass index (BMI) (p>0.05) in the serum ALT, AST, and CKMB activities. However, there was significant difference in ALT and AST activities (P<0.05) but there was no significant difference in serum CKMB activity (P>0.05). Statistically the percentage of the participants that had their serum ALT activity above the reference range were 16.6%, those within the reference range were 83.4%,. In serum AST activity, the percentage above the reference range were 19.9%, those within the reference range were 80.1%. Meanwhile, in serum CK-MB activity, those above the reference range were 25.2% while those within the reference range were 74.8%. Conclusion: This could be probably indicate that the leakage of AST and ALT activities may be of hepatic origin. . The non-significant increase in CKMB which is a specific marker of myocardial injury, could suggest that the subjects were not at risk of developing of myocardial infarction as regards their age.
Clinical Profile of Acute Coronary Syndrome among Young AdultsPremier Publishers
Acute Coronary Syndrome accounts for 30% of hospital admissions with cardiovascular diseases. The risk of this syndrome is increasing among the younger adults, and a deep insight into the clinical profile among these patients will help in devising a preventive strategy, in order to alleviate the morbidity and mortality due to the syndrome. A cross sectional study was done among 125 subjects admitted to our tertiary care hospital with Acute Coronary Syndrome. Their risk factors were assessed and a 12 Lead electrocardiogram and 2D Echocardiogram were taken. Cardio III panel which consists of Troponin I, CK MB, BNP by COBAS meter machine was also measured. STEMI was present in 73.6% of the patients, while unstable angina was present in 16%. About 90% of STEMI patients were males and 62% of them were hypertensives. LV Ejection Fraction <30% was found in 9% of STEMI patients. This study elucidates the need for a preventive strategy for primordial prevention of cardiovascular events among young adults. The study envisaged the male, urban preponderance towards these events.
CORONARY ARTERY DISEASE is a modern epidemic in india. due to changes in living conditions and habits its prevalence is increasing day by day . in this presentation i have explained the various risk factors and innovations in diagnosis of CAD. IT is very useful for primary health care physicians and community medicine specialist
A Study of the Prevalence of Cardio-Vascular Diseases and Its Risk Factors (B...inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
A Study on Food Habits and Social Habits as Risk Factors among Patients Under...ijtsrd
AIM A study on food habits and social habits as risk factors among patients undergoing Percutaneous Transluminal Coronary Angioplasty PTCA OBJECTIVE To know the association of food habits and social habits as risk factors for PTCA. To observe various co morbidities among the patients To study the bio chemical parameters in patients such as heamoglobin, PVC, platelet count, bilirubin levels. To observe various social habits in the patient, such as smoking and alcohol consumption. Food consumption pattern. METHODOLOGY The sample population n = 60 of 28 80 years of age were chosen from a multi speciality hospital in Hyderabad. All the patients were of different age groups, sex, socio economic status, ethnicity with different co morbidities. A pre tested format consisting of patients profile, subjective data, objective data, biochemical data, medications and 24 hour dietary recall followed by medical nutrition therapy during the hospital stay. RESULTS Among n=60 subjects from 28 80 years of age, the detailed study identified the common risk factors with respect to cardiovascular diseases. The study showed a higher percentage of age from 28 70 years and is mostly in males. Majority of the patients are with increased BMI and are alcholics smokers. Obesity, Hypertension and Diabetes are predominant and dietary patterns recorded are mostly non vegetarians with high calorie, high fat and high protein consumption. CONCLUSION From the result it is very clear that majority of the patients studied with cardiovascular diseases belong to the age group 28 70 years and is mostly seen in males. Majority of them are accompanied with co morbidities with obesity, hypertension and diabetic. And predominantly follow a high calorie and high fat diet .Thus leading to a conclusion that consumption of high calorie and high fat food, presence of co morbidities and smoking could be the risk factors of PTCA. Mrs. Meena Kumari | Mrs. Y. V. Phani Kumari | Gwyneth Madhulika Bashapaga | Ittamala Jaya Rachel ""A Study on Food Habits and Social Habits as Risk Factors among Patients Undergoing Percatenous Transluminal Coronary Angioplasty (PTCA)"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-3 , April 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23372.pdf
Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/23372/a-study-on-food-habits-and-social-habits-as-risk-factors-among-patients-undergoing-percatenous-transluminal-coronary-angioplasty-ptca/mrs-meena-kumari
Heart disease describes a variety of conditions that affect the coronary heart. Diseases underneath the coronary heart sickness umbrella consist of blood vessel diseases, together with coronary artery disorder, heart rhythm problems arrhythmias and heart defects, human beings are born with congenital heart defects , among others. If the heart disorder isnt recognized at an early stage, the patient's situation might get worsened and for that reason endanger his life. Therefore, this software program is evolved in order to research the patient check details and give an evaluation as to whether or not the affected person is healthful or requires remedy for heart disorder by giving the intensity of patient's heart situation because the result. Prof. Vikrant Chole | Karishma V. Bagde "Heart Disease Analysis System" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd31070.pdf Paper Url :https://www.ijtsrd.com/engineering/other/31070/heart-disease-analysis-system/prof-vikrant-chole
Angina Pectoris Pharmacological and Acupuncture Therapyijtsrd
Angina is the most common symptom of ischemic heart disease IHD , it occurs when the heart muscle doesn’t get enough blood as it needs. This usually happen when one or more of the heart arteries is narrowed or blocked, also called ischemia. Which is the major cause of morbidity and mortality worldwide. Approximately 9.8 million patients in the USA have symptoms of angina, through its treatment is challenging. This activity describes the evaluation of management of angina and reviews the role of the health care team improving care for the patients with this condition. It is a common presenting symptom typically, chest pain among patient with coronary artery disease CAD .The atherosclerosis is the main cause of coronary artery obstruction. The pain is typically sever and crushing, and it is characterised by a feeling of squeezing, pressure, heaviness, tightness, or pain in the chest. It can be sudden or repeatedly over a time. Depending on severity, it can be treated by lifestyle changes, especially smoking cessation and regular exercise, medication, angioplasty or surgery and acupuncture therapy can also reduce the symptoms and frequency of angina pain intensity. Angina can accompany or be a precursor or a heart attack. Other cause include abnormal heart rhythms, anaemia, and heart failure. Ms. Deepti | Dr. Priyanka Chaudhary "Angina Pectoris (Pharmacological and Acupuncture Therapy)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd43614.pdf Paper URL: https://www.ijtsrd.commedicine/nursing/43614/angina-pectoris-pharmacological-and-acupuncture-therapy/ms-deepti
Chronic kidney disease (CKD) is a global public health problem
worldwide. The worldwide prevalence of CKD has increased in
various countries such as the U.S. (13.1%), Taiwan (9.8-11.9%),
Norway (10.2%), Japan (12.9-15.1%) China (3.2-11.3%), Korea (7.2- 13.7%), Thailand (8.45-16.3%), Singapore (3.2-18.6%), and Australia(11.2%)
Relationship between Vitamin D Status and Blood Pressure, Age, Physical Activ...CrimsonpublishersNTNF
Relationship between Vitamin D Status and Blood Pressure, Age, Physical Activity, and Nutritional Status in Saudi Males and Females by Tahani Aljurbua in Food Science_ Nutrition Open access Journal
Features of cardiovascular system activity in various climatic & geographical...SanskarVirmani
School of Medicine, V. N. Karazin Kharkiv National University
Department of Human Anatomy and Physiology
University class presentation on the topic "Features of cardiovascular system activity in various climatic & geographical conditions" for the discipline Anatomical & Physiological Aspects of Cardiovascular System by SANSKAR VIRMANI
Presentation is free to use for non-monetary purposes if the author (i.e., me) is properly cited and given due credits.
LinkedIn Profile: bit.ly/SanskarV_LinkedIn
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMPraveen Nagula
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1. See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/8368284
Cardiovascular Disease
Article in BMC Women's Health · September 2004
DOI: 10.1186/1472-6874-4-S1-S15 · Source: PubMed
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BMC Women's Health
Open Access
Report
Cardiovascular Disease
Sherry L Grace*1, Rick Fry2, Angela Cheung3 and Donna E Stewart4
Address: 1University Health Network Women's Health Program, University of Toronto, 657 University Avenue, Toronto, Canada, 2Centre for
Chronic Disease Prevention and Control, Health Canada, 120 Colonnade Rd, Ottawa, Canada, 3University Health Network Women's Health
Program, University of Toronto, 657 University Avenue, Toronto, Canada and 4University Health Network Women's Health Program, University
of Toronto, 657 University Avenue, Toronto, Canada
Email: Sherry L Grace* - sherry.grace@uhn.on.ca; Rick Fry - Rick_fry@hc-sc.gc.ca; Angela Cheung - angela.cheung@uhn.on.ca;
Donna E Stewart - Donna.Stewart@uhn.on.ca
* Corresponding author
Abstract
Health Issue: Cardiovascular disease (CVD) is the leading cause of death in Canadian women and
men. In general, women present with a wider range of symptoms, are more likely to delay seeking
medial care and are less likely to be investigated and treated with evidence-based medications,
angioplasty or coronary artery bypass graft than men.
Key Findings: In 1998, 78,964 Canadians died from CVD, almost half (39,197) were women.
Acute myocardial infarction, which increases significantly after menopause, was the leading cause
of death among women.
Cardiovascular disease accounted for 21% of all hospital admissions for Canadian women over age
50 in 1999. Admissions to hospital for ischemic heart disease were more frequent for men, but the
mean length of hospital stay was longer for women.
Mean blood pressure increases with age in both men and women. After age 65, however, high
blood pressure is more common among Canadian women. More than one-third of postmenopausal
Canadian women have hypertension.
Diabetes increases the mortality and morbidity associated with CVD in women more than it does
in men. Depression also contributes to the incidence and recovery from CVD, particularly for
women who experience twice the rate of depression as men.
Data Gaps and Recommendations: CVD needs to be recognized as a woman's health issue
given Canadian mortality projections (particularly heart failure). Health professionals should be
trained to screen, track, and address CVD risk factors among women, including hypertension,
elevated lipid levels, smoking, physical inactivity, depression, diabetes and low socio-economic
status.
Background
Cardiovascular disease (CVD) is a leading cause of death
in Canadian women and men[1]. In general, the onset of
CVD is approximately 10 years later in women than in
men; women present with a wider range of symptoms[2];
and women are less likely to seek medical care and are less
likely than men to be investigated and treated for CVD
with specific medications, angioplasty or coronary artery
from Women's Health Surveillance Report
Published: 25 August 2004
BMC Women's Health 2004, 4(Suppl 1):S15 doi:10.1186/1472-6874-4-S1-S15
This article is available from: http://www.biomedcentral.com/1472-6874/4/S1/S15
<supplement> <title> <p>Women's Health Surveillance Report</p> </title> <editor>Marie DesMeules, Donna Stewart, Arminée Kazanjian, Heather McLean, Jennifer Payne, Bilkis Vissandjée</editor> <sponsor> <note>The Women's Health Surveillance Report was funded by Health Canada, the Canadian Institute for Health Information (Canadian Population Health Initiative) and the Canadian Institutes of Health Research</note> </sponsor> <note>Reports</note> <url>http://www.biomedcentral.com/content/pdf/1472-6874-4-S1-info.pdf</url> </supplement>
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bypass graft [3-7]. Sex differences have also been
described in CVD risk factors, including cigarette smok-
ing, depression, low income, elevated serum lipids, hyper-
tension, obesity and lack of physical activity[8,9].
Vulnerable subpopulations include Aboriginal
women[10,11], South Asian women[12] and women with
diabetes mellitus[13].
Methods
The results of searches of MEDLINE, PsycINFO and Social
Science Abstracts published in English from 1990 to 2002
were used to select the articles included in the literature
review. Prevalence data were available through self-report
in the National Population Health Survey (NPHS) 1998–
1999 cycle[14] and the 2000 Canadian Community
Health Survey (CCHS)[15]. Vital statistics databases were
analyzed to determine mortality by sex and province[16].
Population rates of hospital admission for CVD by sex
and province were obtained with the use of databases
from the Canadian Institute for Health Information
(CIHI)[1]. Data from the NPHS and the CCHS were ana-
lyzed to determine the associations of risk factors such as
cigarette smoking, leisure-time activity and overweight
with self-reported heart disease, as well as to examine vul-
nerable subgroups according to income, education, eth-
nicity/culture, social support, marital status and family
structure, by sex and province. The results of the Canadian
Heart Health Survey[17] were examined to ascertain the
prevalence of high serum cholesterol levels and hyperten-
sion, and people's knowledge of the major causes of CVD.
International comparisons were obtained from Organiza-
tion for Economic Co-operation and Development
(OECD) data[18].
Results
Prevalence and Incidence
The Canadian prevalence of CVD is available only
through self-reported data from the NPHS or CCHS.
When asked if they had CVD, 3.9% of men and 3.5% of
women responded affirmatively, the highest proportion
being reported by males in the Atlantic provinces[14].
Although the mortality rate for CVD, particularly ischemic
heart disease (IHD), is declining, it is unclear whether the
incidence is decreasing as well or the decline in mortality
simply reflects increased survival[19].
Mortality Rate
In 1998, there were 78,964 deaths attributable to CVD in
Canada, with generally equivalent numbers in men
(39,767) and women (39,197)[15]. Acute myocardial inf-
arction (AMI), incidence of which in women increases sig-
nificantly after menopause and continues to increase with
advanced age, was the overall leading cause of death
among women.
Canadian mortality counts for IHD by sex are presented in
Figure 1. Regional differences in mortality are more nota-
ble for AMI and IHD than for cerebrovascular disease
(CBVD). In 1997, rates of mortality from IHD among
both men and women were highest in Newfoundland and
Labrador; among men they were lowest in Prince Edward
Island, and among women they were lowest in British
Columbia.
With regard to trends over time, mortality rates declined
by half from 1969 to 1997[19]. There is still uncertainty
with regard to the causes of this decline, but it is suspected
that the reduced incidence is partially explained by
declines in risk factors as well as a reduction in case-fatal-
ity due to treatment advances. Over the lifespan, Cana-
dian CVD/CBVD mortality rates increase substantially
with age, and male rates are considerably higher than
female rates for AMI and IHD. Rates of CBVD are similar
among men and women until age 55, after which men
have increased mortality until age 85, when mortality
rates among women become higher.
Morbidity Rate/Hospitalization
Data from the Hospital Morbidity Database of CIHI dem-
onstrate that CVD is the leading cause of hospital admis-
sions for men and women (excluding pregnancy and
childbirth)[1]. CVD accounted for 21% of all hospital
admissions of Canadian women over the age of 50 in
1999, and rates among older women were higher. Admis-
sions to hospital for IHD were more frequent for men
than for women, but the mean length of hospital stay for
women surpassed that for men. Figure 2 presents hospital-
ization rates for IHD among women by age and province.
Male rates increased consistently with age, but there was a
10-year delay in AMI among women, purportedly due to
Ischemic Heart Disease Mortality in Canada, 1979–1998
Figure 1
Ischemic Heart Disease Mortality in Canada, 1979–
1998 Source: Statistics Canada. Vital Statistics, 1999.
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the protective effects of estrogen. The decline in morbidity
is not as strong as the decline in mortality across time.
With regard to provincial variation, Newfoundland and
Labrador, Nova Scotia and New Brunswick figureed par-
ticularly high rates of IHD.
International Comparisons
CVD is the leading cause of death worldwide, but rates
vary considerably between countries. In countries with
established market economies, CVD and CBVD still con-
tribute to approximately half of all deaths in spite of
declines in mortality rates over the past 30 years[20].
Overall, CVD mortality rates are about twice as high
among men as women, but in many countries the actual
number of deaths from CVD among women is similar to
that among men because of their longer life expectancy.
Figure 3 displays the IHD mortality rates from 1960 to
1999 for selected countries per 100,000 females[18]. In
the 1960s, the highest mortality rates for AMI among
women occurred in Australia, New Zealand, Ireland and
the United Kingdom (U.K.), while the lowest rates
occurred in Japan and Mediterranean countries. By the
late 1990s, Canada continued to enjoy lower rates than
the United States and the U.K., but rates were considerably
higher than those found in Asian countries such as Japan
and Korea.
Comorbidities
Hypertension
High blood pressure is an independent risk factor for CVD
in women. Mean blood pressure increases with age in
both women and men, although after age 65 high blood
pressure is more common in Canadian women than
Canadian men[21]. Over one-third of post-menopausal
Canadian women have hypertension. Women tend to be
more aware of the problem than are men and, if the con-
dition is treated, are more likely to have it under control
(see Figure 4).
Lipid Profile
High blood cholesterol in women is a major risk factor for
CVD, and this is amplified by smoking and hypertension.
The prevalence of elevated total lipids in women increases
rapidly after menopause, such that by age 55 women have
higher levels than men (see Figure 5)[24]. Although high
total cholesterol in women does not seem to be as great a
risk as it is in men, the combination of low levels of high-
density lipoprotein (HDL) and elevated triglycerides
increases women's risk of death from CVD tenfold. Forty-
three percent of Canadian women aged 18 to 74 have a
total blood cholesterol above the recommended thresh-
old of 5.2 mmol/L[25]; 32% of women have elevated low-
density lipoprotein levels (> 3.4 mmol/L); and 4% of
women have low HDL levels (< 0.9 mmol/L).
Diabetes Mellitus
Diabetes mellitus (DM) increases rates of mortality and
morbidity from CVD more in women than in men and
eliminates the advantage for women in all atherosclerotic
disease outcomes except stroke [26-29]. Diabetic women
are significantly more likely than diabetic men or non-
diabetic women to have coronary events. DM is often
associated with obesity, a sedentary lifestyle and lower
socio-economic status (SES)[30].
Depression
Depression also contributes to the incidence of and
poorer recovery from CVD [31-36], particularly for
women, who experience twice the rate of depression as
men[37]. Beaudet[38] showed that Canadians aged 55 to
74 who had had a depressive episode in the previous 12
months were nearly three times as likely to have CVD
within the following four years as people who had not
experienced any depressive episode (odds ratio [OR] =
2.7, 95% confidence intervals [CI] 1.01–7.04). Frasure-
Smith et al[39]. analyzed the impact of gender and depres-
sion after AMI in a Canadian sample and found that 8.3%
of the depressed women died of cardiac causes in contrast
to 2.7% of the non-depressed. Depression during hospi-
talization was found to have a significant impact on long-
term mortality, with the increased risk being largely
independent of CVD severity. Patients of both sexes who
experienced depression tended to report more advanced
cardiac disease.
Vulnerable Subgroups
Socio-economic Status
According to self-reported data, Canadian women and
men with CVD tend to have annual income levels in the
Hospitalization Rates for IHD Among Women by Province
and Age, 1994–1998
Figure 2
Hospitalization Rates for IHD Among Women by
Province and Age, 1994–1998 Source: Canadian Institute
for Health Information.
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International Comparisons: IHD Standardized Mortality Rates Among Females, Selected Countries, 1960–1999
Figure 3
International Comparisons: IHD Standardized Mortality Rates Among Females, Selected Countries, 1960–
1999 Adapted from: OECD Health Data 2001[18]. Copyright OECD.
Proportion of Canadians 55 and Older Who Were Aware of
TheirHypertension[22]
Figure 4
Proportion of Canadians 55 and Older Who Were Aware of
TheirHypertension[22]
Proportion of Canadians 55 and Older With Hypertension
and Elevated Blood Lipid Level**
Figure 5
Proportion of Canadians 55 and Older With Hyper-
tension and Elevated Blood Lipid Level** Based on
Heart Health Survey Data 1986–1992[23]
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range of $5,000 to $30,000[14]. Moreover, most Canadi-
ans with self-reported CVD have less than secondary edu-
cation[14], and those with less education are more likely
to show early stage atherosclerosis for any given age
group[40]. Socio-economic determinants act in part
through an increased prevalence of risk factors, but they
also have an independent effect that may be mediated
through social isolation, coping styles, health behaviour,
job strain or stress, and anger or hostility[41,42].
Ethnicity/Culture
Approximately 1 in 5 Canadians is a first-generation
immigrant. In addition to genetic factors, immigrants
tend to bring with them cultural habits (e.g. food choices,
smoking behaviour) that influence their risk of develop-
ing CVD/CBVD[43]. The largest non-European migrant
groups are from China and South Asia, and these groups
show lower all-cause mortality rates among both men and
women. However, South Asian immigrant women have
the highest rate of IHD among Canadian women[19,44].
Studies from the United States show increased rates of
IHD among Black women [45-47]. Canadian data
indicate that 7.3% of Black women versus 2.8% of Black
men have self-reported CVD, as compared with 3.5% and
3.9% for the entire population respectively[14].
Social Support/Family Structure
Social support plays an important role in an individual's
ability to maintain a healthy lifestyle and recover from ill-
ness and surgery [48-51]. This may be a greater problem
for women, many of whom are widowed or isolated[52].
For instance, 6.8% of Canadian men with self-reported
CVD versus 3.9% of women are married, and 15.6% of
men with self-reported CVD versus 16.5% of women are
widowed[14]. Moreover, women with self-reported CVD
are more often living on their own (9.7%), whereas men
are most frequently living with a partner (11.5%)[14].
These differences in risk factors likely arise from the age-
distribution shift in women's CVD.
Associations between Risk Factors and Self-Reported Heart Disease
by Sex
Data from the 2000 CCHS concerning risk factors and vul-
nerable subgroups were used to examine self-reported
heart disease in women and men in a multivariate logistic
regression (Some caveats to the use of a cross-sectional
survey like the CCHS should be noted. Risk factors such as
current daily smoking and current heavy alcohol con-
sumption tend to figure odds ratios that suggest they are
protective for heart disease. This is because of a survey bias
stemming from the fact that many people engage in these
behaviours and do not quit until some related disease has
been diagnosed. Their current smoking and drinking are
truly associated with lack of a diagnosis. Questions in the
NPHS/CCHS surveys are not written in such a way that
responses can be used to definitively characterize long-
term levels of smoking and drinking. For instance, it is not
possible to calculate pack years of smoking from the
CCHS data. The two variables "former daily smoker" and
"ever reduced alcohol consumption for any reason" are
surrogates for past heavy drinking and smoking. They are
biased towards a probability of a current diagnosis of
heart disease, since many people quit their habits on the
advice of a clinician. There is a problem with using a self-
reported heart disease outcome, particularly in elderly
people, among whom it is by far more common and is
greatly under-reported, especially in lower education
groups. Caution is warranted when analyzing prevalent
cases of coronary heart or other frequently fatal diseases,
given that the very high initial mortality may result in the
overrepresentation among prevalent cases of people pro-
tected from a poor prognosis). (see Figure 6). For both
sexes, increasing age, lower household income, former
daily smoking, and BMI of less than 27 all showed a pos-
itive risk for heart disease, and being physically active and
having a higher educational level were protective. How-
ever, although being married appears to be protective for
females it is neither protective nor a risk for males. This is
in line with data presented elsewhere showing that family
structure and social support are integral protective factors
for women.
Risk Factors
Behavioural
Exercise
Physical activity reduces CVD rates of morbidity and mor-
tality among women[53]. The Canadian Heart Health
Survey reported that 36% of Canadian women aged 18 to
74 were classified as physically inactive based on their
self-report of leisure-time physical activities. In the 1998–
1999 NPHS, 53% of Canadian adults were classified as
physically inactive, and this was more prevalent among
Canadian women (56.9%) than men (48.6%)[14], in
populations with lower SES, and with increasing age[54]
(please also refer to the "Personal Health Practices" chap-
ter in this report).
Smoking
Cigarette smoking is the main preventable CVD risk factor
for women and men. It is a stronger risk factor for AMI in
middle-aged women than in men, and in women who use
oral contraceptives[21]. In 1998–1999, more men than
women were daily smokers in all age groups except the
under 24 group (21% of women versus 20% of men)[14].
For instance, daily smoking between the ages of 25 and 39
was reported by 30% of men and 28% of women,
between the ages of 40 and 54 by 28% of men and 24%
of women, and for those aged 55 and over by 18% of men
and 13% of women. Smoking rates tend to be higher in
Quebec and the Atlantic provinces than in other Canadian
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provinces (please also refer to the "Sex And Gender Differ-
ences in Smoking and Self Reported Indicators of Health
in Canadian Women" chapter of this report).
Overweight/Obesity
Obesity is highly prevalent among Canadians, and nota-
ble increases across North America have been the trend.
The Canadian Heart Health Survey[17] reported that 41%
of Canadian women aged 18 to 74 years were overweight
(defined as a BMI of > 25 kg/m2), and 27% were obese
(defined as a BMI > 27 kg/m2). The prevalence of obesity
was shown to increase steadily with age and to be higher
among men than women (please also refer to the "Physi-
cal Activity and Obesity in Canadian Women" chapter of
this report).
Interventions Aimed at Women
Prevention
Mortality from CVD and CBVD among Canadian women
has generally declined over the past three to four dec-
ades[3]. However, given that reduced mortality has been
seen to a greater degree among men and those of north-
western European ancestry, we must do more. Unfortu-
nately, there are currently no representative Canadian
data concerning the efficacy of primary or secondary CVD
prevention programs.
North American data generally show significant sex differ-
ences in referral to and participation in secondary preven-
tion programs such as cardiac rehabilitation (CR) [55-60].
In general, 20% fewer women are enrolled in CR than
Bootstrapped Logistic Regression Analysis for Variables Associated With Self-Reported Heart Disease in Canadian Females
and Males
Figure 6
Bootstrapped Logistic Regression Analysis for Variables Associated With Self-Reported Heart Disease in
Canadian Females and Males. The odds ratio estimates and their associated confidence intervals were calculated using the
Statistics Canada bootstrap weights for the CCHS and the SAS macro program, which was written for that purpose. ‡ Black
and South Asian ethnic status show odds ratios in the direction of a protective effect for both sexes, but the confidence inter-
vals suggest that these are not statistically robust results. This could be because of a lack of statistical power. Despite the
130,000 respondent records in the CCHS, there are relatively few people represented with these ethnic backgrounds who
report currently living with heart disease. Source: 2000 Canadian Community Health Survey (Statistics Canada) (This analysis is
based on the Statistics Canada CCHS, Cycle 1.1, 2000. All computations on these data were done by Health Canada and the
responsibility for the use and interpretation of these data is entirely that of authors.)
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men,[61,62] a proportion significantly lower than
expected on the basis of morbidity[63]. Despite women's
lower participation[64,65], women of all ages benefit
from CR [66-69], with improvements in functional
capacity, coronary risk and psychosocial well-being that
are comparable with or exceed those of men[66].
Diagnosis/Detection Programs
A gap exists in Canadian CVD surveillance data with
regard to diagnosis and detection programs. Data from
the Canadian Heart Health Survey (1986–1992) show
that risk factors for CVD are under-diagnosed and under-
detected. For instance, only 42% of Canadians with
hypertension were aware that they had hypertension[22].
Of those aged 18 to 74, 26% of men and 18% of women
were hypertensive. Among men, 47% were unaware of
their hypertensive state, for 21% the condition was not
treated and was uncontrolled, for 19% it was treated but
not controlled, and for 13% it was treated and under con-
trol. Among women, 35% were unaware of their hyper-
tensive status, for 15% it was not treated and was
uncontrolled, for 29% it was treated but not controlled,
and for 20% it was treated and under control[70].
Treatment/Interventions
Canadian female AMI patients in every age group are less
likely to undergo either percutaneous transluminal coro-
nary angioplasty (PTCA) or coronary artery bypass graft-
ing (CABG) revascularization[1,71]. This may be partially
explained by women's higher age at CVD onset, given that
the best candidates for revascularization are younger indi-
viduals without comorbid conditions.
Discussion
Data Limitations
To improve our understanding and management of CVD
among women, we must examine surveillance capabili-
ties, research methodologies, and heart health policies
and services (see also the gaps identified in the bulleted
points below). With regard to the surveillance of the diag-
nosis and detection of CVD, we urgently need incidence
estimators at the population level (such as the MONICA/
ICONS project in Nova Scotia). We lack data on recent
physical measures (i.e. hypertension, lipid profiles), for
which self-reporting is notoriously poor. We need recent
data on who is undergoing treatment for hypertension,
hyperlipidemia and depression, and the effectiveness of
these treatments. We are unable to capture the number of
women or men undergoing stress tests, angiography,
echocardiography or 24-hour blood pressure monitoring.
Information on risk factor incidence and prevalence
across the lifespan is also lacking. Methodologically
speaking, person-oriented data for women (and men)
would enable us to follow Canadians longitudinally
through the health care system and across the lifespan.
Surveillance data regarding health services evaluation are
lacking. We are unable to determine the prevalence of
medication prescription, compliance with treatment, or
prevention of CVD and CBVD. Physician service utiliza-
tion data for CVD/CBVD (as compared with those with-
out CVD/CBVD), patient access to physician offices for
prevention of CVD/CBVD (i.e. determined through physi-
cian billing data at the provincial level), and hospitaliza-
tion data for patients with CVD/CBVD versus those
without it are deficient. In short, the following gaps are
notable:
• incidence indicators at the population level;
• recent data on physical measures, such as hypertension
and lipid profile;
• information on people undergoing treatment for hyper-
tension and hyperlipidemia, and the control rate;
• person-oriented data to follow people through the
health care system;
• prevalence of prevention and detection programs,
including community heart health and smoking cessation
programs;
• national drug data for the treatment and prevention of
CVD/CBVD;
• the changing prevalence of congestive heart failure; and
• the number of women and men undergoing stress tests,
angiograms, echocardiography and holteronitoring.
Policy Considerations
With regard to healthy public policy, CVD needs to be rec-
ognized as a women's health issue, given the Canadian
mortality projections, the aging population, and rampant
inequities in health care access and provision. Health pro-
fessionals should be trained to screen and address CVD
risk factors in women, such as hypertension, elevated lipid
levels, smoking, physical inactivity, depression, diabetes
mellitus and low SES. We need to continue developing
and evaluating educational resources for women across
the lifespan regarding their risk for CVD and symptom
presentation. Efforts to encourage healthy eating habits
and physical activity through a multiplicity of approaches
should be pursued. This may include working with local
governments, workplaces, health care providers and the
media to promote the importance of physical activity
while recognizing the unique circumstances of women
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and girls (e.g. by providing a safe environment). Finally,
attention must be paid to barriers to physical activity
among women of diverse ethnocultural backgrounds and
social classes.
Notes
The views expressed in this report do not necessarily rep-
resent the views of the Canadian Population Health
Initiative, the Canadian Institute for Health Information
or Health Canada.
References
1. Canadian Institute for Health Information: Hospital Mortality Database.
Ottawa: CIHI 2002.
2. Milner KA, Funk M, Richards S, Wilmes RM, Vaccarino V, Krumholz
HM: Gender differences in symptom presentation associated
with coronary heart disease. Am J Cardiol 1999, 84:396-399.
3. Heart and Stroke Foundation of Canada: Women, heart disease and
stroke in Canada. Ottawa 1997.
4. Kudenchuk P, Maynard C, Martin J, Wirkus M, Weaver WD: Com-
parison of presentation, treatment, and outcome of acute
myocardial infarction in males versus females. Am J Cardiol
1996, 78:9-14.
5. Majeed FA, Cook DG: Age and sex differences in the manage-
ment of ischaemic heart disease. Public Health 1996, 110:7-12.
6. Schwartz LM, Fisher ES, Tostson ANA, Woloshin S, Chang C, Virnig
BA, et al.: Treatment and health outcomes of women and men
in a cohort with coronary artery disease. Arch Intern Med 1997,
157:1545-1551.
7. Vaccarino V, Krumholz HM, Yarzebski J, Gore JM, Goldberg RJ: Sex
differences in two-year mortality after hospital discharge for
myocardial infarction. Ann Intern Med 2001, 134(3):173-181.
8. Abbey S, Stewart DE: Gender and psychosomatic aspects of
ischemic heart disease. J Psychosom Res 2000, 48(5):417-423.
9. Lonn E: Epidemiology of ischemic heart disease in women: women and
ischemic heart disease. Canadian Cardiovascular Society, Consensus
Conference. 2000.
10. Shah BR, Hux JE, Zinman B: Increasing rates of ischemic heart
disease in the native population. Arch Intern Med 2001,
160(12):1862-1866.
11. Anand S, Tookenay V: Cardiovascular diseases and aboriginal
peoples. Can J Cardiol 1999, 15(Suppl G):44G-46G.
12. Shin AY, Anand SS, Wall C, Tu JV, Yusuf S, Naylor DC: Ethnoracial
origins and heart disease. In: Cardiovascular health and services in
Ontario Edited by: Naylor DC, Slaughter PM. Toronto: Institute for Clinical
Evaluative Sciences and Heart and Stroke Foundation of Ontario;
1999:267-282.
13. Shin AY, Jaglal S, Slaughter PM, Iron K: Women and heart disease.
In: Cardiovascular health and services in Ontario Edited by: Naylor DC,
Slaughter PM. Toronto: Institute for Clinical Evaluative Sciences and Heart
and Stroke Foundation of Ontario; 1999:336-354.
14. Statistics Canada: National Population Health Survey: 1998–99. Ottawa:
Health Statistics Division, Statistics Canada. .
15. Canadian Community Health Survey: [http://www.statcan.ca/english/
concepts/health/.].
16. Statistics Canada: Vital statistics 1999.
17. MacLean DR, Petrasovits A, Nargundkar M, et al.: Canadian Heart
Health Surveys: a profile of cardiovascular risk. Survey
methods and data analysis. Canadian Heart Health Surveys
Research Group. Can Med Assoc J 1992, 146(11):1969-1974.
18. Organization for Economic Co-operation and Development. International
mortality data. OECD 2001.
19. Heart and Stroke Foundation of Canada: The changing face of
heart disease and stroke in Canada. Ottawa 2000:1-107.
20. Advisory Board of the First International Conference on
Women, Heart Diseases and Stroke. The 2000 Victoria dec-
laration on women, heart diseases, and stroke. CVD Prev 2000,
3:174-327.
21. Heart and Stroke Foundation of Canada: Heart disease and stroke in
Canada. Ottawa 1995.
22. Kirkland SA, MacLean DR, Langille DB, Joffres MR, MacPherson KM,
Andreou P: Knowledge and awareness of risk factors for car-
diovascular disease among Canadians 55 to 74 years of age:
results from the Canadian Heart Health Surveys, 1986–1992.
Can Med Assoc J 1999, 161(Suppl 8):S10-S16.
23. Langille DB, Joffres MR, MacPherson KM, et al.: Prevalence of risk
factors for cardiovascular disease. Can Med Assoc J 1999,
161:S3-S9.
24. Connelly PW, MacLean DR, Horlick L, O'Connor B, Petrasovits A,
Little JA: Plasma lipids and lipoproteins and the prevalence of
risk for coronary heart disease in Canadian adults. Can Med
Assoc J 1992, 146(11):1977-1987.
25. Health Canada: Canadians and heart health: reducing the risk. Ottawa
1995.
26. Wilson PWF: Diabetes mellitus and coronary heart disease.
Am J Kidney Dis 1999, 32(Suppl 3):S89-S100.
27. Sowers JR: Diabetes mellitus and cardiovascular disease in
women. Arch Intern Med 1998, 158:617-621.
28. Pan WH, Cedres LB, Liu K: Relationship of clinical diabetes and
asymptomatic hyperglycemia to risk of coronary heart dis-
ease mortality in men and women. Am J Epidemiol 1986,
123(3):504-516.
29. Gaba MK, Gaba S, Clark LT: Cardiovascular disease in patients
with diabetes: clinical considerations. J Assoc Academic Minority
Physicians 1999, 10(1):15-22.
30. Beckles GL, Thompson-Reid PE: Socioeconomic status of
women with diabetes – United States 2000. MMWR 2002,
51(7):147-148.
31. Ferketich AK, Schwartzbaum JA, Frid DJ, Moeschberger ML: Depres-
sion as an antecedent to heart disease among women and
men in the NHANES I study. Arch Intern Med 2000,
160(9):1261-1268.
32. Lane D, Carroll D, Ring C, Beevers DG, Lip GYH: Effects of depres-
sion and anxiety on mortality and quality-of-life four months
after myocardial infarction. J Psychosom Res 2000, 49:229-238.
33. Stansfeld SA, Fuhrer R, Shipley MJ, Marmot M: Psychological dis-
tress as a risk factor for coronary heart disease in the White-
hall II study. Int J Epidemiol 2002, 31:248-255.
34. Schwartzman JB, Glaus KD: Depression and coronary heart dis-
ease in women: implications for clinical practice and
research. Professional Psychology: Research and Practice 2000,
31(1):48-57.
35. Ziegelstein R, Fauerbach J, Stevens S, Romanelli J, Ritcher D, Bush D:
Patients with depression are less likely to follow recommen-
dations to reduce cardiac risk during recovery from a myo-
cardial infarction. Arch Intern Med 2000, 160(12):1818-1823.
36. Wassertheil-Smoller S, Applegate WB, Berge K, Chang CJ, Davis BR,
Grimm R, et al.: Change in depression as a precursor of cardi-
ovascular events. Arch Intern Med 1996, 156:553-561.
37. Nolen-Hoeksema S, Larson J, Grayson C: Explaining the gender
difference in depressive symptoms. J Pers Soc Psychol 1999,
77(5):1061-1072.
38. Beaudet M: Depression and incident heart disease. Toronto: Annual Epide-
miology Conference 2001.
39. Frasure-Smith N, Lesperance F, Juneau M, Talajic M, Bourassa MG:
Gender, depression, and one-year prognosis after myocar-
dial infarction. Psychosom Med 1999, 61(1):26-37.
40. Gallo LC, Matthews KA, Kuller LH, Sutton-Tyrrell K, Edmundowicz
D: Educational attainment and coronary aortic calcification
in post-menopausal women. Psychosom Med 2001,
63(6):925-935.
41. Escobedo LG, Giles WH, Anda RF: Socioeconomic status, race,
and death from coronary heart disease. Am J Prev Med 1997,
13:123-130.
42. Kaplan G, Keil J: Socioeconomic factors and cardiovascular dis-
ease: a review of the literature. Circulation 1993, 88(4 pt
1):1973-1998.
43. Rubia M, Marcos I, Muenning AP: Increased risk of heart disease
and stroke among foreign-born females residing in the
United States. Am J Prev Med 2002, 22(1):30-35.
44. Bhopal R: Epidemic of cardiovascular disease in South Asians.
BMJ 2002, 324:625-626.
45. Rosenberg L, Palmer JR, Rao RS, Adams-Campbell LL: Risk factors
for coronary heart disease in African-American women. Am J
Epidemiol 1999, 150(9):904-909.
46. Sundquist J, Winkleby MA, Pudaric S: Cardiovascular disease risk
factors among older Black, Mexican-American, and White
women and men: an analysis of NHANES III, 1988–1994.
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Page 9 of 9
(page number not for citation purposes)
Third national health and nutrition examination. J Am Geriatr
Soc 2001, 49(2):109-116.
47. Tofler GH, Stone PH, Muller JE: Effects of gender and race on
prognosis after myocardial infarction: adverse prognosis for
women, particularly Black women. J Am Coll Cardiol 1987,
9(3):473-482.
48. Cohen S, Kaplan JR, Manuck SB: Social support and coronary
heart disease: underlying psychological and biological mech-
anisms. In: Social support and cardiovascular disease. Plenum series in
behavioral psychophysiology and medicine Edited by: Shumaker SA, Cza-
jkowski SM. New York: Plenum Press; 1994:195-221.
49. Ell K, Dunkel-Schetter C: Social support and adjustment to
myocardial infarction, angioplasty, and coronary artery
bypass surgery. In: Social support and cardiovascular disease. Plenum
series in behavioral psychophysiology and medicine Edited by: Shumaker
SA, Czajkowski SM. New York: Plenum Press; 1994:301-332.
50. Holahan CJ, Moos RH, Holahan CK, Brennan PL: Social support,
coping, and depressive symptoms in a late-middle-aged sam-
ple of patients reporting cardiac illness. Health Psychol 1995,
4(2):152-163.
51. Orth-Gomer K: International epidemiological evidence for a
relationship between social support and cardiovascular dis-
ease. In: Social support and cardiovascular disease. Plenum series in
behavioral psychophysiology and medicine Edited by: Shumaker SA, Cza-
jkowski SM. New York: Plenum Press; 1994:97-117.
52. Brummett BH, Barefoot JC, Siegler IC, Clapp-Channing NE, Lytle BL,
Bosworth HB, et al.: Characteristics of socially isolated patients
with coronary artery disease who are at elevated risk for
mortality. Psychosom Med 2001, 63:267-274.
53. Stephens T: International trend in the prevalence of physical activity and
other health determinants. Orlando: Federation international de médecin du
sport, World Congress of Sports Medicine 1998.
54. Statistics Canada: National Population Health Survey overview, 1996–97.
Ottawa: Minister of Industry, Cat. No. 82-567-XPB 1998.
55. Barber K, Stommel M, Kroll J, Holmes-Rovner M, McIntosh B: Car-
diac rehabilitation for community-based patients with myo-
cardial infarction: factors predicting discharge
recommendation and participation. J Clin Epidemiol 2001,
54(10):1025-1030.
56. Burns KJ, Camaione DN, Froman RD, Clark BA: Predictors of
referral to cardiac rehabilitation and cardiac exercise self-
efficacy. Clin Nurs Res 1998, 7(2):147-163.
57. Cannistra LB, Balady GJ, O'Malley CJ, Weiner DA, Ryan TJ: Compar-
ison of the clinical profile and outcome of women and men
in cardiac rehabilitation. Am J Cardiol 1992, 69:1274-1279.
58. Carhart R, Ades P: Gender differences in cardiac rehabilitation.
Cardiol Clin 1998, 16(1):37-43.
59. Caulin-Glaser T, Blum M, Schmeizl R, Prigerson HG, Zaret B, Mazure
CM: Gender differences in referral to cardiac rehabilitation
programs after revascularization. J Cardiopulm Rehabil 2001,
21:24-30.
60. Cristian A, Mandy K, Root B: Comparison between men and
women admitted to an inpatient rehabilitation unit after
cardiac surgery. Arch Phys Med Rehabil 1999, 80:183-185.
61. Grace SL, Abbey S, Shnek Z, Irvine J, Franche RI, Stewart D: Cardiac
rehabilitation II: referral and participation. Gen Hosp Psychiatry
2002, 24(3):127-134.
62. Ades P, Waldmann M, Polk D, Coflesky J: Referral patterns and
exercise response in the rehabilitation of female coronary
patients aged > 62 years. Am J Cardiol 1992, 69:1422-1425.
63. Thomas R, Miller N, Lamendola C, Berra K, Hedback B, Durstine J, et
al.: National survey of gender differences in cardiac rehabili-
tation programs. J Cardiopulm Rehabil 1996, 16:402-412.
64. Hawthorne MH: Women recovering from coronary artery
bypass surgery. Scholarly Inquiry for Nursing Practice: An International
Journal 1993, 7(4):223-52.
65. Schuster P, Waldron J: Gender differences in cardiac rehabilita-
tion patients. Rehabil Nurs 1991, 16(5):248-253.
66. O'Callaghan W, Teo K, O'Riordan J, Webb H, Dolphin T, Horgan JH:
Comparative response of male and female patients with cor-
onary artery disease to exercise rehabilitation. Eur Heart J
1984, 5:649-651.
67. Oldridge N, LaSalle D, Jones N: Exercise rehabilitation of female
patients with coronary heart disease. Am Heart J 1980,
100:755-757.
68. O'Farrell P, Murray J, Huston P, LeGrand C, Adamo K: Sex differ-
ences in cardiac rehabilitation. Can J Cardiol 2000,
16(3):319-325.
69. Lavie C, Milani R, Cassidy M, Gilliland Y: Effects of cardiac rehabil-
itation and exercise training programs in women with
depression. Am J Cardiol 1999, 83:1480-1483.
70. Joffres MR, Ghadirian P, Fodor JG, Petrasovits A, Chockalingam A,
Hamet P: Awareness, treatment, and control of hypertension
in Canada. Am J Hypertens 1997, 10(10):1097-1102.
71. Johansen H, Nair C, Wolfson M: Revascularization and heart
attack outcomes. Health Rep 2002, 13(2):35-46.
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