Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway
Abstract Background Cardiovascular disease (CVD) mortality is substantially higher in Russia than in neighbouring Norway. We aimed to compare blood pressure- and lipid-lowering medication use and proportion meeting treatment targets between general population samples in the two countries in those wi...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12872-020-01513-1 |
| _version_ | 1818341390677966848 |
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| author | Sarah Cook Laila A. Hopstock Anne Elise Eggen Katie Bates Olena Iakunchykova Anna Kontsevaya Martin McKee Henrik Schirmer Michael Voevoda Alexander V. Kudryavtsev Sofia Malyutina David A. Leon |
| author_facet | Sarah Cook Laila A. Hopstock Anne Elise Eggen Katie Bates Olena Iakunchykova Anna Kontsevaya Martin McKee Henrik Schirmer Michael Voevoda Alexander V. Kudryavtsev Sofia Malyutina David A. Leon |
| author_sort | Sarah Cook |
| collection | DOAJ |
| description | Abstract Background Cardiovascular disease (CVD) mortality is substantially higher in Russia than in neighbouring Norway. We aimed to compare blood pressure- and lipid-lowering medication use and proportion meeting treatment targets between general population samples in the two countries in those with CVD and diabetes. Methods The study population was adults aged 40–69 years reporting a diagnosis of myocardial infarction (MI), stroke and/or diabetes participating in cross-sectional population-based studies in Russia (Know Your Heart (KYH) 2015–18 N = 626) and Norway (The Tromsø Study 2015–16 (Tromsø 7) N = 1353). Reported medications were coded according to the 2016 WHO Anatomical Therapeutic Chemical Classification system. Treatment targets were defined using the Joint European Societies guidelines for CVD prevention in clinical practice (2016). Results Age- and sex-standardized prevalence of use of lipid-lowering medications was higher in Tromsø 7 for all three conditions with a disproportionately large difference in those reporting MI (+ 48% (95% CI 39, 57%)). Proportion meeting treatment targets for LDL cholesterol was poor in both studies (age- and sex-standardized prevalence of control KYH vs Tromsø 7: MI 5.1% vs 10.1%; stroke 11.6% vs 5.8%; diabetes 24.9% vs 23.3%). Use of antihypertensive medication was higher in KYH for stroke (+ 40% (95% CI 30, 50%)) and diabetes (+ 27% (95% CI 19, 34%)) groups but approximately equal for the MI group (− 1% (95% CI -1, 1%)). Proportion meeting blood pressure targets was lower in KYH vs Tromsø 7 (MI 51.8% vs 76.3%; stroke 49.5% vs 69.6%; diabetes 51.9% vs 63.9%). Conclusions We identified different patterns of medication use in people with CVD and diabetes. However despite higher use of lipid-lowering medication in the Norwegian study treatment to target for total cholesterol was poor in both Russian and Norwegian studies. In contrast we found higher levels of use of antihypertensive medications in the Russian study but also that less participants met treatment targets for blood pressure. Further work should investigate what factors are responsible for this seeming paradox and how management of modifiable risk factors for secondary prevention could be improved. |
| first_indexed | 2024-12-13T15:58:02Z |
| format | Article |
| id | doaj.art-d55beb710d60435bacefb25293da4e64 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-13T15:58:02Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-d55beb710d60435bacefb25293da4e642022-12-21T23:39:15ZengBMCBMC Cardiovascular Disorders1471-22612020-05-0120111110.1186/s12872-020-01513-1Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and NorwaySarah Cook0Laila A. Hopstock1Anne Elise Eggen2Katie Bates3Olena Iakunchykova4Anna Kontsevaya5Martin McKee6Henrik Schirmer7Michael Voevoda8Alexander V. Kudryavtsev9Sofia Malyutina10David A. Leon11Department of Community Medicine, UiT The Arctic University of NorwayDepartment of Community Medicine, UiT The Arctic University of NorwayDepartment of Community Medicine, UiT The Arctic University of NorwayDepartment of Health Services Research and Policy, London School of Hygiene & Tropical MedicineDepartment of Community Medicine, UiT The Arctic University of NorwayNational research center for preventive medicineDepartment of Health Services Research and Policy, London School of Hygiene & Tropical MedicineAkershus University HospitalResearch Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of SciencesDepartment of Community Medicine, UiT The Arctic University of NorwayResearch Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of SciencesDepartment of Community Medicine, UiT The Arctic University of NorwayAbstract Background Cardiovascular disease (CVD) mortality is substantially higher in Russia than in neighbouring Norway. We aimed to compare blood pressure- and lipid-lowering medication use and proportion meeting treatment targets between general population samples in the two countries in those with CVD and diabetes. Methods The study population was adults aged 40–69 years reporting a diagnosis of myocardial infarction (MI), stroke and/or diabetes participating in cross-sectional population-based studies in Russia (Know Your Heart (KYH) 2015–18 N = 626) and Norway (The Tromsø Study 2015–16 (Tromsø 7) N = 1353). Reported medications were coded according to the 2016 WHO Anatomical Therapeutic Chemical Classification system. Treatment targets were defined using the Joint European Societies guidelines for CVD prevention in clinical practice (2016). Results Age- and sex-standardized prevalence of use of lipid-lowering medications was higher in Tromsø 7 for all three conditions with a disproportionately large difference in those reporting MI (+ 48% (95% CI 39, 57%)). Proportion meeting treatment targets for LDL cholesterol was poor in both studies (age- and sex-standardized prevalence of control KYH vs Tromsø 7: MI 5.1% vs 10.1%; stroke 11.6% vs 5.8%; diabetes 24.9% vs 23.3%). Use of antihypertensive medication was higher in KYH for stroke (+ 40% (95% CI 30, 50%)) and diabetes (+ 27% (95% CI 19, 34%)) groups but approximately equal for the MI group (− 1% (95% CI -1, 1%)). Proportion meeting blood pressure targets was lower in KYH vs Tromsø 7 (MI 51.8% vs 76.3%; stroke 49.5% vs 69.6%; diabetes 51.9% vs 63.9%). Conclusions We identified different patterns of medication use in people with CVD and diabetes. However despite higher use of lipid-lowering medication in the Norwegian study treatment to target for total cholesterol was poor in both Russian and Norwegian studies. In contrast we found higher levels of use of antihypertensive medications in the Russian study but also that less participants met treatment targets for blood pressure. Further work should investigate what factors are responsible for this seeming paradox and how management of modifiable risk factors for secondary prevention could be improved.http://link.springer.com/article/10.1186/s12872-020-01513-1Secondary preventionRussian FederationNorwayMyocardial infarctionStrokeDiabetes |
| spellingShingle | Sarah Cook Laila A. Hopstock Anne Elise Eggen Katie Bates Olena Iakunchykova Anna Kontsevaya Martin McKee Henrik Schirmer Michael Voevoda Alexander V. Kudryavtsev Sofia Malyutina David A. Leon Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway BMC Cardiovascular Disorders Secondary prevention Russian Federation Norway Myocardial infarction Stroke Diabetes |
| title | Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway |
| title_full | Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway |
| title_fullStr | Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway |
| title_full_unstemmed | Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway |
| title_short | Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway |
| title_sort | pharmacological management of modifiable cardiovascular risk factors blood pressure and lipids following diagnosis of myocardial infarction stroke and diabetes comparison between population based studies in russia and norway |
| topic | Secondary prevention Russian Federation Norway Myocardial infarction Stroke Diabetes |
| url | http://link.springer.com/article/10.1186/s12872-020-01513-1 |
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