Trends and disparities in coronary artery disease prevalence among U.S. adults from 2019 to 2022.

BACKGROUND: Coronary artery disease (CAD) is the leading cause of death in the U.S. Understanding trends and potential disparities in CAD prevalence is crucial for public health strategies. OBJECTIVE: Examine trends and disparities in CAD prevalence among U.S. adults (2019-2022). METHODS: CDC's National Health Interview Survey's data was analyzed, employing regression analysis with Joinpoint and ARIMA models by ChatGPT-4 for trend forecasting. RESULTS: CAD prevalence among U.S. adults was relatively stable, increasing slightly from 4.6 % (95 % CI: 4.3-4.9) in 2019 to 4.9 % (95 % CI: 4.7-5.2) in 2022. Males experienced significant rise in prevalence, with an APC of 3.1 % (95 % CI: 1.45-4.85, p-value < 0.000001), increasing from 5.9 % to 6.4 %. Female prevalence also increased significantly, with APC of 2.0 % (95 % CI: 0.46-3.59, p-value = 0.003599), moving from 3.4 % to 3.6 %. Notable age-related disparities appeared, especially in those aged 75 and over, with rates peaking at 20.0 % in 2020 before decreasing to 19.7 % in 2022. Racial disparities revealed higher prevalence among White adults at 5.4 % and noticeable increase among Asian adults from 2.8 % to 3.8 %. Geographic factors also influenced prevalence, particularly outside metropolitan areas, Northeast, and South regions of US. Employment status influenced CAD rates and a lower prevalence observed in the employed (1.7 % to 1.9 %) compared to unemployed (9.9 % to 10.3 %). Veterans (13.4 % to 12.6 %) reported higher prevalence rates than non-veterans. ARIMA projections suggest stable prevalence until 2026. CONCLUSION: Despite stable overall prevalence, significant disparities exist. Targeted interventions are essential, particularly for high-risk demographics such as males, older adults, and veterans.

Assessment of postgraduate educational environment in public and private hospitals of Karachi.

OBJECTIVE: To assess the environment of postgraduate fellowship training in teaching hospitals of an urban centre. METHODS: The cross-sectional study was conducted at one public-sector and two private-sector teaching hospitals in Karachi from December 2014 to June 2015. Data was collected by using a modified version of Postgraduate Hospital Educational Environment Measure, a validated questionnaire, for which clinical residents were selected through convenience sampling. Data was analyzed using SPSS 16. RESULTS: Of the 302 participants, 168(55.6%) were males and 134(44.4%) were females. The overall mean age of the respondents was 28.46±3.03 years. The internal reliability of the questionnaire was good with a Cronbach's alpha of 0.92. The overall mean score of 93.96±20.79suggested more positive than negative perception with room for improvement. After adjusting for all important socio-demographic and residency co-variates, residency in a private hospital was positively associated with Postgraduate Hospital Educational Environment Measure score (p<0.01) compared to residency in public hospitals. CONCLUSIONS: There is an urging need to standardise postgraduate training in terms of teaching, autonomy and social support in public and private hospitals of Karachi.