ABSTRACT
Objective To analyze the mortality rate and probability of premature death caused by four major noninfectious chronic diseases (NCDs)in Linyi City from 2013 to 2021, and to provide data support for scientific formulation of chronic disease prevention and control strategy. Methods The mortality data of major chronic diseases in Linyi City from 2013 to 2021 were analyzed. The crude mortality, age-standardized mortality and premature death probability were calculated. The annual percent change (APC) was adopted to analyze the temporal trend of mortality and probability of premature death. Results The average annual crude mortality of four major NCDs was 538.98/100,000, and the age-standardized mortality was 387.3/100,000. The crude mortality rate increased from 517.37/100 000 in 2013 to 563.13/100 000 in 2021 (APC=0.89％, P=0.01). The age-standardized mortality rate decreased from 410.19/100,000 to 364.92/100,000 (APC=-1.8％, P=0.01). The crude mortality and age-standardized mortality of four major NCDs in males were higher than those in females (P<0.05). The average annual probability of premature death caused by four major NCDs was 13.37%. The probability of premature death decreased from 14.49％ in 2013 to 12.32％ in 2021（APC=-2.1％, P=0.00）. From 2013 to 2021, the probability of premature death from malignant tumors, cardiovascular and cerebrovascular diseases, and chronic respiratory diseases in Linyi City dropped from 6.14%, 7.47%, and 1.21% to 5.52%, 6.46%, and 0.5%, respectively (APCs were -1.2%, -2.1%, and -11.3%, respectively, and P values were 0.04, 0.00, and 0.00, respectively). The probability of premature death from diabetes remained stable. The probability of premature death caused by four major NCDs in males was higher than that in females (P<0.05). Conclusion The probability of premature death of the four major NCDs in Linyi has showed a downward trend during 2013-2021. It is suggested to strengthen the prevention and control of diabetes in the next step.
ABSTRACT
Fundamento: las enfermedades cerebrovasculares constituyen una de las principales causas de mortalidad en el mundo. En las Américas constituyen la tercera causa de muerte y su incidencia se ve aumentada en los pacientes diabéticos tipo 2. Objetivo: caracterizar los pacientes diabéticos tipo 2 con enfermedad cerebrovascular isquémica aguda. Método: se realizó un estudio descriptivo en pacientes diabéticos que ingresaron en el Hospital Calixto García con diagnóstico de enfermedad cerebrovascular isquémica aguda en el período comprendido entre enero y diciembre 2022. El universo estuvo constituido por la totalidad de pacientes diabéticos tipo 2 que ingresaron en la Institución y la población por 148 pacientes. Las variables analizadas fueron: sexo, color de piel y edad; tensión arterial e índice de masa corporal; colesterol, triacilgliceridos y glicemia; tipo enfermedad cerebrovascular y su gravedad y comorbilidades. Se utilizaron métodos de la estadística descriptiva como frecuencia absoluta y porciento. Los resultados se presentaron en tablas creadas a los efectos. Resultados: predominó el sexo masculino, el color de piel blanca y el grupo etáreo entre los 60 y 69 años con un 58,1 43,9 y 40,5 % respectivamente. Predominaron los pacientes hipertensos y con sobrepeso relacionados con la mayor gravedad de la enfermedad cerebrovascular, los pacientes hiperglicémicos con valores de colesterol y triacilgliceridos altos, en ellos fue más grave el evento isquémico cerebral. La hipertensión arterial y la cardiopatía isquémica prevalecieron en la población estudiada con un 81,8 y 52,7 respectivamente. Conclusiones: la enfermedad cerebrovascular fue más frecuente en el sexo masculino, color de piel blanca y pacientes de edad avanzada. La hipertensión arterial, el sobrepeso, la hiperglucemia así como los valores altos de colesterol y triglicéridos predominaron en la muestra y se relacionaron con la mayor gravedad del evento cerebrovascular isquémico.
Foundation: cerebrovascular diseases are one of the main causes of mortality in the world. In the Americas they constitute the third cause of death and their incidence is increased in type 2 diabetic patients. Objective: to characterize type 2 diabetic patients with acute ischemic cerebrovascular disease. Method: a descriptive study was carried out in diabetic patients who were admitted to the Calixto García Hospital with a diagnosis of acute ischemic cerebrovascular disease in the period between January and December 2022. The universe consisted of all type 2 diabetic patients who were admitted to the Institution and the population of 148 patients. The variables analyzed were: sex, skin color and age; blood pressure and body mass index; cholesterol, triacylglycerides and glycemia; type of cerebrovascular disease and its severity and comorbidities. Descriptive statistical methods such as absolute frequency and percentage were used. The results were presented in tables created for the purpose. Results: the male sex, the white skin color and the age group between 60 and 69 years predominated with 58.1, 43.9 and 40.5 % respectively. Hypertensive and overweight patients related to the greater severity of cerebrovascular disease, hyperglycemic patients with high cholesterol and triacylglyceride values predominated, and in them the cerebral ischemic event was more severe. Arterial hypertension and ischemic heart disease prevailed in the studied population with 81.8 and 52.7 respectively. Conclusions: cerebrovascular disease was more frequent in males, white skin color and elderly patients. Arterial hypertension, overweight, hyperglycemia as well as high cholesterol and triglyceride values predominated in the sample and were related to the greater severity of the ischemic cerebrovascular event.
ABSTRACT
Objective:To evaluate the hemodynamic changes and short-term (one year) outcomes after superficial temporal artery(STA)-middle cerebral artery (MCA) bypass by vascular ultrasonography.Methods:Operation group included a total of 41 hemispheres of 38 patients who underwent STA-MCA bypass for severe stenosis or occlusion of MCA or severe stenosis or occlusion of internal carotid artery(ICA), or Moyamoya disease at Xuanwu Hospital between August 2017 and June 2020. The following examinations were performed in all patients: cranial MRI, CT perfusion imaging, and cerebral angiography. All of the patients were retrospectively followed up for one year postsurgery. Normal group included a total of 40 hemispheres of 20 healthy people who had been examined by vascular ultrasonography of carotid artery and intracranial artery. Inner diameter, peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV), resistance index (RI), pulsatility index (PI) and flow of STA, PSV, EDV, MV, PI, RI of external carotid artery (ECA) and PSV, EDV, MV, PI, RI of MCA at 1 week, 6 months and 12 months after STA-MCA bypass of operation group were compared with normal group.Results:①Inner diameter, PSV, MV and flow of STA were increased significantly in operation group at 1 week, 6 and 12 months than normal group (all P<0.05). The flow of STA was decreased significantly from 1 week to 12 months after operation (all P<0.05), but Inner diameter, PSV and MV were only decreased gradually from 1 week to 12 months after operation (all P>0.05). ②STA/ECA PI and RI decreased significantly after operation compared with normal group (all P<0.01). Conclusions:Vascular ultrasonography is a non-invasive examination which can objectively evaluate the extracranial and intracranial hemodynamic changes after STA-MCA bypass, and provide reference effectiveness of the operation. The flow of STA has decreased gradually from 1 week to 12 months after operation to achieve the homeostasis, but it is still higher than normal.STA/ECA PI and RI can be a steady indirect pointer to show the fluency of bypass.
ABSTRACT
Objective@#To investigate the mortality of malignant tumors, diabetes, cardio-cerebrovascular diseases and chronic respiratory diseases and trends in probability of premature mortality due to these four chronic diseases in Jiangmen City, Guangdong Province from 2012 to 2021, so as to provide the evidence for perfecting the chronic disease control strategy. @*Methods@#The mortality of malignant tumors, diabetes, cardio-cerebrovascular diseases and chronic respiratory diseases among household registered residents in Jiangmen City from 2012 to 2021 were collected from the Guangdong Provincial Population Death Information Registration Management System, and the crude mortality, standardized mortality by the population of the Fifth National Population Census in China in 2000 and probability of premature mortality were calculated. The trends in mortality and probability of premature mortality were analyzed using average annual percent change (AAPC), and whether achieving the targets for the probability of premature mortality due to four chronic diseases in 2025 and 2030 were evaluated.@*Results@#A total of 226 012 deaths occurred due to four chronic diseases in Jiangmen City from 2012 to 2021, and the overall crude mortality and standardized mortality rates were 569.22/105 and 283.29/105, with a reduction in the probability of premature mortality from 15.04% to 12.05% (AAPC=-2.403%, Z=-7.603, P<0.001). The probability of premature mortality due to four chronic diseases decreased from 19.21% to 16.38% in males, and from 10.42% to 7.58% in females (AAPC=-1.893% and -3.085%, Z=-5.262 and -9.811, both P<0.001). The probability of premature mortality due to diabetes appeared a tendency towards a rise (AAPC=2.317%, Z=2.548, P=0.034), and the probability of premature mortality due to cardio-cerebrovascular diseases showed a tendency towards a decline (AAPC=-4.826%, Z=-13.590, P<0.001), while no significant changing trend was seen in the probability of premature mortality due to malignant tumors or chronic respiratory diseases (AAPC=-0.751% and -2.461%, Z=-1.532 and -1.730, P=0.125 and 0.122). The predicted probability of premature mortality due to four chronic diseases was 10.92% in 2025 and 9.66% in 2030 in Jiangmen City, which were both lower than the target (11.21% and 9.81%). @*Conclusions@#The probability of premature mortality due to four chronic diseases appeared a tendency towards a decline in Jiangmen City from 2012 to 2021, which can reach the target in 2025 and 2030. Males should be given a high priority for interventions of chronic diseases, and diabetes control should be reinforced.
ABSTRACT
Objective To analyze the changing trend of disease burden attributable to renal insufficiency in cardiovascular disease (CVD) among the elderly in China from 1990 to 2019, and to forecast the disability-adjusted life years (DALY) in the next 10 years, so as to provide a reference basis for accurate prevention and control of CVD attributable to renal insufficiency in China. Methods Data were obtained from the Global Health Data Exchange (GHDx) database to describe the current status of CVD prevalence attributable to renal insufficiency. The joinpoint model was used to estimate the annual percentage change and average annual percentage change to assess the temporal trend of CVD attributable to renal insufficiency in China. An autoregressive moving average model was created by R4.0.2 software to predict the disease burden of CVD attributable to renal insufficiency in China. Results Compared with 1990, CVD mortality and DALY rates attributed to renal insufficiency increased in the male elderly population and decreased in women. Mortality and DALY rates attributed to ischemic heart disease, ischemic stroke, and peripheral arterial disease attributed to renal insufficiency showed an increasing trend, and mortality and DALY rates for cerebral hemorrhage decreased. There was an overall increasing trend in the attribution of CVD due to renal insufficiency. Conclusion The burden of diseases attributable to renal insufficiency in Chinese elderly with CVD is relatively high, and the impact on each disease is different, which requires the attention of relevant authorities.
ABSTRACT
MicroRNAs (miRNAs) are endogenous non-coding single-stranded small RNAs that regulate gene expression by recognizing homologous sequences and interfering with transcriptional, translational or epigenetic processes. MiRNAs are involved in a variety of disease processes, and regulate the physiological and pathological status of diseases by modulating target cell activity, migration, invasion, apoptosis, autophagy and other processes. Among them, let-7i is highly expressed in various systems, which participates in the process of tumors, cardiovascular and cerebrovascular diseases, fibrotic diseases, inflammatory diseases, neurodegenerative diseases and other diseases, and plays a positive or negative regulatory role in these diseases through different signal pathways and key molecules. Moreover, it can be used as an early diagnosis and prognostic marker for a variety of diseases and become a potential therapeutic target. As a biomarker, let-7i is frequently tested in combination with other miRNAs to diagnose multiple diseases and evaluate the clinical treatment or prognosis.
Subject(s)
Biomarkers , Apoptosis , Autophagy , Epigenesis, Genetic , MicroRNAs/geneticsABSTRACT
Objective To explore the impact of temperature and environmental factors on the risk of deaths from cardiovascular and cerebrovascular diseases (CVD) in Wuhan during the course of high temperature. Methods The daily CVD death data and meteorological and atmospheric pollutant concentration data during the high temperature process in Wuhan from 2014 to 2019 were collected. The generalized additive models (GAM) were used to obtain the characteristics of meteorological factors, atmospheric pollutant concentrations, high impact factors and thresholds affecting the relative risk of CVD death. Results The analysis results showed that: (1) When the maximum temperature reached 36.7°C and the lowest temperature reached 25.3°C, the relative risk of CVD death increased significantly; (2) The risk of CVD death during the first high temperature process was the largest, and the average CVD excess mortality rate during the first high temperature process from 2014 to 2019 reached 21.7%; and (3) The average temperature, maximum temperature and PM10 during the course of high temperature were important environmental factors that increased the risk of CVD deaths, and the relative risks were 1.14 (95% confidence interval (95% CI): 1.11-1.17), 1.11 (95% confidence interval (95% CI): 1.08-1.15, and 1.06 (95% confidence interval (95% CI): 1.02-1.09), respectively. Conclusion Temperature and PM10 are important environmental factors that increase the risk of death from CVD during the high temperature process in Wuhan from 2014 to 2019, with the first annual high temperature process having the greatest impact on the risk of CVD death.
ABSTRACT
Resumo Introdução A doença cerebrovascular (DCBV) é a segunda principal causa de morte no mundo e no Brasil. Objetivo Avaliar as tendências da mortalidade por DCBV em duas cidades brasileiras (Maceió e Florianópolis) com diferenças socioeconômicas extremas, entre 1981 e 2015, estimando os efeitos idade, período e coorte. Método Estudo de séries temporais da mortalidade por DCBV em indivíduos com ≥ 40 anos, empregando a ferramenta Web tool. Resultados A mortalidade por DCBV diminuiu com o tempo, aumentou com a idade e foi menor para gerações mais novas. O efeito foi igual para ambos os sexos. Houve diminuição da mortalidade nas duas cidades, mas a diferença foi grande e a mortalidade continua alta em Maceió. Com base na amplitude dos efeitos estimados, foi possível verificar que o efeito de coorte foi o termo mais significativo para explicar a variabilidade temporal das taxas de mortalidade por DCBV no período. Conclusão A comparação da tendência temporal nas duas cidades mostrou a importância da melhora das condições de vida, do acesso a serviços de saúde para prevenção e controle dos fatores de risco, assim como assistência hospitalar aos casos para diminuirmos a mortalidade por DCBV em todo o território nacional.
Abstract Background Cerebrovascular disease (CBVD) is the second leading cause of death in the world and Brazil. Objective To evaluate trends in mortality from CBVD in two Brazilian cities (Maceió and Florianópolis) with extreme socioeconomic differences, between 1981 and 2016, estimating the age, cohort effect. Method Study of CBVD mortality time series in individuals aged ≥40 years, using the Age, Period, Cohort (APC) analysis and the Web tool. Results CBVD mortality decreased with time, increased with age and was lower for younger generations. The effect was the same for both sexes. There was a decrease in mortality in both cities, but the difference was large, and mortality remains high in Maceió. Based on the amplitude of the estimated effects, it was possible to verify that the cohort effect was the most significant term to explain the temporal variability of mortality rates due to CVD in the period. Conclusion The comparison of the time trend in the two cities showed the importance of improving living conditions, access to health services for the prevention and control of risk factors, as well as hospital care for cases to reduce mortality from CVD nationwide.
ABSTRACT
Introducción: En Consolación del Sur la enfermedad cerebrovascular constituye la tercera causa de muerte así como para el resto del país, lo que denota una afectación considerable en gran parte de la población. Objetivo: Caracterizar los factores de riesgo de la enfermedad cerebrovascular en pacientes de 60 años y más. Métodos: Se realizó un estudio descriptivo de corte transversal y prospectivo en el Consejo Popular de "Alonso Rojasˮ perteneciente al Policlínico "5 de Septiembreˮ en el período comprendido entre octubre de 2015 y septiembre de 2019. El universo y la muestra estuvieron constituido por 41 pacientes con el diagnóstico de enfermedad cerebrovascular, los cuales cumplieron con los criterios establecidos en la investigación. Se emplearon métodos de nivel teórico, empírico y procedimientos estadísticos. Resultados: Se analizó el comportamiento de las variables edad, color de la piel, sexo, obesidad, sedentarismo, antecedentes de la enfermedad cerebrovascular, alcoholismo, tabaquismo, hipertensión arterial, tipo de enfermedad cerebrovascular, tipo de discapacidad y grado de validismo. Conclusiones: La enfermedad cerebrovascular se encuentra en pacientes con más de 60 años, con predominio del sexo masculino de tipo isquémico en la raza blanca, cuyo principal factor de riesgo fue el sedentarismo, tiene como secuelas invalidantes, trastornos de la memoria y la parálisis de los miembros inferiores, con un grado de validismo II.
Introduction: In Consolación del Sur, cerebrovascular disease is the third cause of death as well as for the rest of the country, which denotes considerable effect in a large part of the population. Objective: To characterize the risk factors for cerebrovascular disease in patients aged 60 years and over. Methods: A descriptive cross-sectional and prospective study was carried out in Alonso Rojas Popular Council from 5 de Septiembre Polyclinic between October 2015 to September 2019. Fourty one patients with the diagnosis of cerebrovascular disease formed the universe and the sample, they met the inclusion criteria established in the investigation. Theoretical and empirical methods and statistical procedures were used. Results: The behavior of the variables age, skin color, sex, obesity, sedentary lifestyle, history of cerebrovascular disease, alcoholism, smoking, arterial hypertension, type of cerebrovascular disease, type of disability and degree of validism was analyzed. Conclusions: Cerebrovascular disease is found in patients over 60 years of age. We found male predominance of the ischemic type in white skin subjects, whose main risk factor was sedentary lifestyle. This disease has disabling sequelae, memory disorders and paralysis of the the lower limbs, with a degree of validism II.
ABSTRACT
Objective@#To examine the dose-response association between cardiorespiratory fitness ( CRF ) and the risk of cardiovascular and cerebrovascular diseases.@*Methods@#A joint search was performed in Chinese and English electronic databases, including China National Knowledge Infrastructure ( CNKI ) , Wanfang Data, VIP, CBM, PubMed, Embase and Web of Science, to retrieve publications reporting the correlation between CRF and the risk of cardiovascular and cerebrovascular diseases until May, 2021. The pooled risk was estimated using the random effects model, and the dose-response association was evaluated using restricted cubic splines. The source of heterogeneity was assessed by subgroup analysis, and the stability of the results was tested by the trim-and-fill method, while the publication bias was assessed using funnel plots.@*Results@#Totally 37 280 literatures were identified, and 23 eligible studies were finally included in the analysis, which covered 2 605 622 subjects. There were 22 publications identified as high-quality. Meta-analysis revealed that the pooled risk of cardiovascular and cerebrovascular diseases reduced by 42% in the highest CRF group relative to the lowest CRF group ( OR=0.58, 95%CI: 0.52-0.65 ), and a one metabolic equivalent ( MET ) increase in CRF caused a 10% reduction in the pooled risk of cardiovascular and cerebrovascular diseases ( OR=0.90, 95%CI: 0.88-0.92 ). There was a negative linear correlation between CRF and the incidence of cardiovascular and cerebrovascular diseases ( P=0.396 ). Subgroup analysis identified gender, sample size and study regions as possible sources of heterogeneity, and sensitivity analysis showed that the study results were stable.@*Conclusions@#There is a negative linear correlation between CRF and the risk of cardiovascular and cerebrovascular diseases, and an increase in CRF may reduce the risk of cardiovascular and cerebrovascular diseases.
ABSTRACT
Objective @#To investigate the mortality of cardiovascular and cerebrovascular diseases and to examine the effects on life expectancy among residents in Yuhang District of Hangzhou City from 2010 to 2020, so as to provide insights into the management of cardiovascular and cerebrovascular diseases.@*Methods@#The mortality surveillance data of cardiovascular and cerebrovascular diseases of registered residents in Yuhang District from 2010 to 2020 were collected from Zhejiang All-cause Death Surveillance System. The crude mortality, standardized mortality, annual percent change ( APC ), Fulfillment index, life expectancy, cause-eliminated life expectancy and years of life lost, and the mortality of cardiovascular and cerebrovascular diseases and the impact on life expectancy were analyzed.@*Results@#A total of 21 761 deaths occurred due to cardiovascular and cerebrovascular diseases in Yuhang District from 2010 to 2020, and the annual average crude and standardized mortality rates of cardiovascular and cerebrovascular diseases were 206.14/105 and 129.62/105, respectively. The annual crude and standardized mortality of cardiovascular and cerebrovascular diseases both appeared a tendency towards a decline from 2010 to 2020, with APC of -3.63% and -5.45%, respectively ( P<0.05 ), and the Fulfillment index showed a tendency towards a reduction in residents at ages of 50 to 79 years ( P<0.05 ). The mean life expectancy and cause-eliminated life expectancy were 82.71 and 88.39 years in Yuhang District from 2010 to 2020, which both appeared a tendency towards a rise, both with APC of 0.50% ( P<0.05 ). The years of life lost were 5.02 to 6.47 years due to cardiovascular and cerebrovascular diseases, and the life loss rates were 6.00% to 7.73%.@*Conclusions@#The mortality of cardiovascular and cerebrovascular diseases appeared a tendency towards a decline decreased and the cause-eliminated life expectancy appeared a tendency towards a rise in Yuhang District from 2010 to 2020. Intensifying the management of cardiovascular and cerebrovascular diseases death may increase the life expectancy.
ABSTRACT
Objectives To investigate the effects of low level of ambient NO2 on the death of cardiovascular and cerebrovascular diseases in Enshi city and to identify sensitive population, so as to provide a scientific basis for formulating health policies. Methods The data of air pollutants, meteorological factors and death of cardiovascular and cerebrovascular diseases in Enshi city from 2015 to 2018 were collected. The generalized additive model based on Poisson distribution was used to analyze the effects of low ambient NO2 level on the death risk of cardiovascular and cerebrovascular diseases in Enshi city. A subgroup analysis was performed on age, gender, and season. Results The average concentrations of major gaseous air pollutants in Enshi city from 2015 to 2018 were NO2 (21.40 μg/m3), SO2 (9.68 μg/m3), CO (0.88 mg/m3), and O3 (61.21 μg/m3), respectively, all of which did not exceed the national secondary standard. The results of single pollutant model analysis showed that each 1 μg/m3 increase in NO2 concentration in lag0 day was associated with a 0.33% increase (95% CI: 0.06 - 0.72) (P>0.05) in mortality risk of cardiovascular and cerebrovascular diseases. In the female population, each 1 μg/m3 increase in NO2 concentration in lag01 day was associated with a 0.92% increase (95% CI: 0.26 - 1.56) (P2 concentration in lag0 day was associated with a 0.62% increase (95% CI: 0.12 - 1.12) (P2, CO or O3), the effect of NO2 on the mortality risk of cardiovascular and cerebrovascular diseases in women and the whole population in cold season still existed. Conclusion The low ambient level of NO2 in Enshi city was significantly associated with increased mortality risk of cardiovascular and cerebrovascular diseases in female population as well as in cold seasons in the whole population. Attention should be paid to the health protection of special populations in areas with low ambient pollution level of NO2 in special seasons.
ABSTRACT
Air pollution has severe detrimental effects on public health.A substantial number of studies have demonstrated that air pollution exposure is a risk factor for the occurrence of cardiovascular and cerebrovascular diseases and a cause of non-communicable diseases.Both long-term and short-term exposure to air pollution are associated with respiratory diseases,stroke,coronary artery disease,and diabetes.Aiming to better understand the association,we reviewed the latest studies about the association of air pollution with cardiovascular and cerebrovascular diseases,especially stroke,coronary heart disease,arrhythmia,hypertension,and heart failure,and summarized the underlying mechanisms of the health damage caused by long-term and short-term exposure to air pollution.
Subject(s)
Humans , Air Pollutants/analysis , Air Pollution/adverse effects , Cardiovascular Diseases/etiology , Cerebrovascular Disorders/etiology , Environmental Exposure/analysis , Particulate Matter/analysis , Stroke/complicationsABSTRACT
Objective To analyze the composition and influencing factors of the hospitalization expenses of patients with cardiovascular and cerebrovascular diseases who has participated in basic medical insurance, and to provide evidence for controlling excessive increase in the hospitalization expenses and reducing the financial burden of patients. Methods The hospitalization information of 14,271 insured patients with cardiovascular and cerebrovascular diseases from January 1, 2019 to December 31, 2019 in Xianning City, Hubei Province was retrospectively collected. The basic information of the patients and the composition of their hospitalization expenses were descriptively analyzed, and the influencing factors of hospitalization expenses of the patients were analyzed by univariate analysis and logistic regression analysis. Results Among the patients included in the study, coronary heart disease, cerebral infarction, cerebral hemorrhage and essential hypertension were the four main types of cardiovascular and cerebrovascular diseases with the largest proportion of hospitalization expenses, accounting for 26.18%, 20.29%, 11.82% and 9.94%, respectively. The largest proportion of hospitalization expenses was treatment expenses and drug expenses, accounting for 44.09% and 32.52%, respectively. Logistic regression analysis showed that age, length of stay, type of insurance, type of cardiovascular and cerebrovascular diseases, whether there were other comorbidities or complications, and whether they visited tertiary medical institutions were the influencing factors of hospitalization expenses for patients with cardiovascular and cerebrovascular diseases. Conclusion It is necessary to strengthen the disease prevention and control for the elderly and patients with cardiovascular and cerebrovascular diseases such as coronary heart disease, cerebral infarction, cerebral hemorrhage and essential hypertension, accelerate the integration of the basic medical insurance system, scientifically and reasonably shorten the length of hospital stay, and strengthen the promotion of the hierarchical medical system.
ABSTRACT
As doenças cardiovasculares (DCV) são a principal causa de morte no Brasil e no mundo. As doenças isquêmicas do coração (DIC) e doenças cerebrovasculares (DCBV) estão entre as dez principais causas de mortes no Brasil. A análise de tendência da mortalidade por DCV permite definir populações prioritárias para intervenções, elaborar e avaliar ações em saúde pública. Nesse sentido, o objetivo do estudo foi analisar a tendência da mortalidade por DIC e DCBV nas 27 capitais brasileiras, no período de 1990 a 2018. Trata-se de um estudo ecológico de série temporal, os dados de óbitos foram obtidos através do Sistema de Informações sobre Mortalidade (SIM). Buscando corrigir problemas na qualidade da informação dos registros de óbito do SIM, realizou-se a correção dos óbitos referentes aos dados com sexo e/ou faixa etária ignorada e aos óbitos registrados com causas "mal definidas". As taxas de mortalidade por DIC e DBCV foram padronizadas pelo método direto, tomando-se como população padrão a população do Brasil no ano de 2010. A análise de tendência da mortalidade por DIC e DCBV para a população total, homens e mulheres foi realizada utilizando o modelo de regressão de Poisson. Os resultados mostraram tendência de redução da mortalidade por DCBV tanto para a população total como para homens e mulheres em todas as capitais brasileiras. Vitória, capital da região Sudeste, apresentou a maior redução da taxa de mortalidade total por DCBV dentre todas as capitais brasileiras, -5,6% ao ano (IC95%: -6,0; -5,1%). No entanto, Macapá, capital da região Norte, teve a menor dentre todas as capitais -1,7% ao ano (IC95%: -2,7; -0,7%). Paras as DIC foi observada tendência de redução da mortalidade tanto para a população total como para homens e mulheres nas capitais das regiões Sul, Sudeste e para a maioria das capitais da região Centro-Oeste. As capitais das regiões Norte e Nordeste apresentaram uma variabilidade na tendência da mortalidade por DIC. Conclui-se que as capitais das regiões Sul e Sudeste apresentaram as maiores reduções da tendência da mortalidade por DIC e DCBV. Os achados desse estudo são importantes para prover informações mais detalhadas buscando auxiliar a gestão local na promoção de políticas de saúde pública, planejamento de estratégias e elaboração de medidas e ações em saúde.
Cardiovascular diseases (CVD) are the leading cause of death in Brazil and worldwide. Ischemic heart diseases (IHD) and cerebrovascular diseases (CBVD) are among Brazil's ten main causes of death. The trend analysis of mortality from CVD allows defining priority populations for interventions, designing and evaluating public health actions. In this sense, the study's objective was to analyze the mortality trend from IHD and CBVD in the 27 Brazilian capitals from 1990 to 2018. This is an ecological time-series study with the Mortality Information System (SIM) data. Seeking to correct the quality of the information in the SIM death records, the correction of deaths referring to data with anonymous sex and age group and deaths recorded with "ill-defined" causes was carried out. IHD and CBVD mortality rates were standardized by the direct method, using the population of Brazil in 2010 as the standard population. Trend analysis of IHD and CBVD mortality for the total population, men and women, was performed using the Poisson regression model. The results showed a reduction in the trend of mortality from CBVD for both the total population and for men and women in all Brazilian capitals. Vitória, the capital of the Southeast region, showed the greatest reduction in the total mortality rate from CVD among all Brazilian capitals, -5.6% per year (95%CI: -6.0; -5.1%). However, Macapá, the capital of the North region, had the lowest among all capitals -1.7% per year (95%CI: -2.7; -0.7%). For IHD, a decrease in the mortality trend was observed both for the total population and for men and women in the capitals of the South and Southeast regions and most capitals of the Center-West region. The capitals of the North and Northeast regions showed variability in the trend of IHD mortality. In conclusion, the capitals of the South and Southeast regions showed the greatest reductions in the mortality trend due to IHD and CBVD. The findings of this study are essential to provide more detailed information to assist local management in promoting public health policies, planning strategies, and designing health measures and actions.
Subject(s)
Humans , Cardiovascular Diseases/mortality , Cerebrovascular Disorders/mortality , Time Series Studies , Myocardial Ischemia/mortality , Brazil , EpidemiologyABSTRACT
Resumo Fundamento: A mortalidade por doenças cardiovasculares (DCV) vem mostrando tendência à estabilização em alguns países, incluindo o Brasil e o estado do Rio de Janeiro, após décadas de queda. Não encontramos análises detalhadas dessa tendência para o estado do Rio de Janeiro. Objetivo: Analisar as tendências da mortalidade prematura e tardia por doenças do aparelho circulatório (DAC), doença isquêmica do coração (DIC) e doença cerebrovascular (DCBV) por sexo nas regiões de saúde do estado do Rio de Janeiro e capital (1996-2016). Métodos: Dados de óbitos e população foram obtidos no DATASUS/MS. Taxas foram compensadas por códigos mal definidos, corrigidos pelos códigos cardiovasculares mal definidos e ajustadas por sexo e idade pelo método direto. O Joinpoint Trend Analysis Software foi empregado para calcular a variação percentual anual (APC) e variação percentual anual média (AAPC). Foram consideradas para o estudo APC e AAPC significativamente diferentes de zero, calculadas por um teste de student com significância de 5%. Resultados: A mortalidade por DIC estabilizou ou até aumentou em pelo menos 50% das localidades analisadas (EAPC ≥0). Nas regiões Norte e Noroeste, nenhuma mudança foi observada. Para DCBV, apenas uma região apresentou estabilidade na mortalidade (EAPC próximo a 0). Para as outras regiões, a taxa continuou a diminuir (APC <0) até 2016. Conclusão: Esses resultados observados no Rio de Janeiro devem se repetir em várias regiões brasileiras e apontam para a necessidade de uma resposta na abordagem dos comportamentos no estilo de vida. Os médicos da atenção primária devem estar familiarizados com a tendência desfavorável da doença isquêmica do coração entre os adultos mais jovens e rastrear ativamente os fatores de risco para DCV, com atenção especial às mulheres.
Abstract Background: Cardiovascular disease (CVD) mortality, after several decades of decrease, has shown a tendency towards the stabilization in some countries, including Brazil and Rio de Janeiro state. This new tendency was not further analyzed by gender, age group and region of the Rio de Janeiro state. Objective: To analyze the trends of premature and late mortality from CVD, ischemic heart disease (IHD) and cerebrovascular disease (CBVD) by gender in the city of Rio de Janeiro (capital) and the health regions of Rio de Janeiro state (from 1996 to 2016. Methods: Data on deaths and the population were obtained from DATASUS/MS. The rates were compensated by ill-defined codes, corrected by Ill-Defined Cardiovascular codes and gender and age-adjusted by the direct method (reference population - population of the state of Rio de Janeiro - 2000 census). The Joinpoint Trend Analysis Software was employed. Results: IHD mortality stabilized or even increased for at least 50% of the analyzed areas (EAPC≥0). No change was observed. in the "North" and "Northwest" regions For CBVD, just one region showed stability regarding mortality (EAPC close to 0). For the other regions, the rate continued to decrease (APC<0) until 2016. Conclusion: These results observed in Rio de Janeiro are possibly appropriate to various Brazilian regions and demonstrate that a serious public health response is needed to address lifestyle behaviors. Primary care physicians should also be familiar with the unfavorable tendency in coronary heart disease among younger adults in recent years and actively screen for risk factors for cardiovascular disease, paying special attention to women.
Subject(s)
Humans , Female , Adult , Cardiovascular Diseases , Cerebrovascular Disorders , Myocardial Ischemia , Brazil/epidemiology , CitiesABSTRACT
La actual pandemia de COVID-19 causada por el virus SARS-CoV-2, se caracteriza por una alta morbilidad y mortalidad. Algunos estudios han reportado que la frecuencia de ictus en pacientes infectados con el virus oscila entre un 5-20 por ciento. A pesar de estas cifras alarmantes, las vías por las cuales el virus llega al sistema nervioso central y los mecanismos fisiopatológicos por los que puede ocurrir un ictus en estos pacientes no han sido totalmente esclarecidos. Numerosos estudios han demostrado que la infección por SARS-CoV-2 está asociada a un estado protrombótico, capaz de causar un tromboembolismo arterial y venoso. Además, se ha reportado una respuesta inflamatoria exacerbada, con reclutamiento de células sanguíneas y una secreción desproporcionada de citoquinas proinflamatorias. También la hipoxia y fenómenos cardioembólicos han sido propuestos como posibles mecanismos. Es esencial definir con exactitud los mecanismos fisiopatológicos que vincula la infección por SARS-CoV-2 con la ocurrencia del ictus, con la finalidad de aplicar tratamientos más específicos y evitar futuras complicaciones(AU)
The actual Coronavirus Disease 2019 (COVID-19) infection is an ongoing pandemic, characterized by high morbidity and mortality produced by SARS-CoV-2 virus. Studies reported a stroke frequency around 5-20 percent in infected patients; however, SNC invasion and pathophysiological mechanisms related to stroke in COVID-19 patients are still unknown. Several studies have demonstrated that SARS-CoV-2 infection is linked to a prothrombotic state causing venous and arterial thromboembolism. Also, an overstated inflammatory response with recruitment of blood cells and disproportioned secretion of proinflammatory cytokines has been reported. Finally, cardioembolism and hypoxia have been proposed as surrogate mechanisms. It is essential to define the pathophysiological mechanisms of stroke during the infection in order to apply more specific treatments to avoid further stroke complications(AU)
Subject(s)
Humans , Cytokines , Bodily Secretions , Stroke , COVID-19 , HypoxiaABSTRACT
Cardiovascular and cerebrovascular diseases are one of the major diseases endangering human health， and its morbidity and mortality are still in the rising stage in our country. Traditional Chinese medicine （TCM） injections play an important role in the prevention and treatment of cardiovascular and cerebrovascular diseases due to their advantages of rapid onset， remarkable curative effect， and convenient use. Among them， Danhong injection （DHI）， a Chinese medicine injection for promoting blood circulation and removing blood stasis， is widely used in the clinical treatment of cardio-cerebrovascular diseases. DHI is composed of Salviae Miltiorrhizae Radix et Rhizoma （Danshen in Chinese） and Carthami Flos （Honghua in Chinese）， and mainly contains phenolic acids， tanshinones and flavonoids. A large number of studies have shown that DHI has a significant effect in the treatment of ischemic cardio-cerebrovascular diseases， is a representative drug of co-therapy of brain and heart of TCM， its pharmacological effects related to many aspects such as anti-inflammatory， anti-oxidation， anti-coagulation. At the same time， Other studies have also explained the protective effects of DHI on cardiovascular and cerebrovascular diseases through the overall regulation and intervention of multiple targets and pathways. However， DHI has a wide range of clinical applications， there are still many unknown pharmacological effects to be further explored. Therefore， this article summarizes the current researches on the chemical components of DHI， the multi-target and multi-path pharmacological mechanisms of DHI in the treatment of cardiovascular and cerebrovascular diseases， and introduces the latest pharmacological research progress， so as to provide theoretical guidance for clinical rational drug use and subsequent in-depth research.
ABSTRACT
BACKGROUND: It is generally known that PI3K/Akt/mTOR, MAPK, Jak/Stat, NF-κB and Notch signaling pathways play important roles in cell proliferation and differentiation, gene transcription, and immune inflammation. Hypoxia inducible factor-1α (HIF-1α) plays a crucial role in mediating the hypoxia signaling pathway and acts as a core factor in the hypoxic reaction process. OBJECTIVE: To summarize the relationship between HIF-1α and hypoxia signaling pathways, providing new ideas for the research and treatment of altitude diseases. METHODS: English literatures published during 2000-2019 were retrieved from PubMed and Medline. Chinese literatures published during 2011-2019 were retrieved from CNKI and WanFang databases. Search terms were “hypoxia inducible factor 1α, signal pathway” in English and Chinese, respectively. RESULTS AND CONCLUSION: During the occurrence of hypoxic-related diseases (inflammation, tumor, cardiovascular and cerebrovascular diseases) and altitude disease, the expression levels of HIF-1 and the key factors of these signaling pathways can change to varying degrees. HIF-1 is closely related to these signaling pathway under the hypoxic conditions, regulates molecular expression in these signaling pathways, or are regulated by these signaling pathways to increase or decrease, in response to the changes in the body under hypoxia conditions.
ABSTRACT
BACKGROUND: Hypoxia is a common physiological and pathological stress response in various diseases, and exosomes are widely involved in the mechanism of hypoxia injury and its adaptive mechanism. The two are closely related, which is the current research hotspot. OBJECTIVE: To find a new target for the prevention and treatment of high altitude diseases and open up new ideas. METHODS: The PubMed and Medline databases from 2013 to 2020, and the CNKI and Wanfang databases from 2018 to 2019 were searched by computer. The key words were “serum exosomes, hypoxia, tumor, inflammation, cardiovascular and cerebrovascular diseases” in Chinese and English. Finally, 57 articles were included in the review. RESULTS AND CONCLUSION: Hypoxia is a potential environmental death factor by affecting cell cycle, morphology, metabolism, proliferation, differentiation, autophagy, apoptosis and so on. Hypoxia can regulate the release and change the content of exosomes, which is strongly associated with cell specificity, the duration of hypoxia exposure and the severity of hypoxia. In the environment of hypoxia, exosomes can transmit all kinds of biological information and play an important role in biology through specific binding with receptor cells. As a biomarker of disease diagnosis, exosomes have great potential.