{"id":31022,"date":"2014-02-01T00:00:00","date_gmt":"2018-12-03T22:39:39","guid":{"rendered":"https:\/\/aprifel-pp.mentalworks.biz\/fr\/resume-scientifique\/effect-of-cardiovascular-prevention-strategies-on-incident\/"},"modified":"2018-12-03T23:39:39","modified_gmt":"2018-12-03T22:39:39","slug":"effect-of-cardiovascular-prevention-strategies-on-incident","status":"publish","type":"resume","link":"https:\/\/aprifel-pp.mentalworks.biz\/fr\/resume-scientifique\/effect-of-cardiovascular-prevention-strategies-on-incident\/","title":{"rendered":"Effect of cardiovascular prevention strategies on incident coronary disease hospitalisation rates in Spain; an ecological time series analysis."},"content":{"rendered":"<p><strong>OBJECTIVE<\/strong><br \/>\nTo assess the overall population impact of primary prevention strategies (promotion of healthy lifestyles, prevention of smoking and use of vascular risk drug therapy) of coronary disease in Spain.<\/p>\n<p><strong>DESIGN<\/strong><br \/>\nEcological time series analysis, 1982-2009.<\/p>\n<p><strong>SETTING<\/strong><br \/>\nAll public and private hospitals in Spain.<\/p>\n<p><strong>PARTICIPANTS<\/strong><br \/>\nGeneral population.<\/p>\n<p><strong>OUTCOME<\/strong><br \/>\nIncident coronary disease hospitalisation as derived from official hospital discharge data.<\/p>\n<p><strong>METHODS<\/strong><br \/>\nAnnual hospitalisation rates were modelled according to nationwide use of statins, antihypertensive, antidiabetic and antiplatelet drugs, and prevalences of smoking, obesity and overweight. Additive generalised models and mixed Poisson regression models were used for the purpose, taking year as the random-effect variable and adjusting for age, sex, prevalence of vascular risk factors and the number of hospital beds in intensive and coronary care units.<\/p>\n<p><strong>RESULTS<\/strong><br \/>\nAcross 28 years and 671.5 million person-years of observation, there were 2 986 834 hospitalisations due to coronary disease; of these, 1 441 980 (48.28%) were classified as incident. Hospitalisation rates increased from 1982 to 1996, with an inflection point in 1997 and a subsequent 52% decrease until 2009. Prevalences of smoking, obesity, overweight and use of vascular risk drug therapy were significantly associated with hospitalisation rates (p&lt;0.001): incidence rates ratios (95% CI) for the fourth versus the first quartile were 1.46 (1.42 to 1.50), 1.80 (1.78 to 1.83), 1.58 (1.55 to 1.60) and 0.57 (0.51 to 0.63), respectively. These variables accounted for 92% of interannual variability.<\/p>\n<p><strong>CONCLUSIONS<\/strong><br \/>\nAfter decades of continuous rises, hospitalisation due to incident ischaemic heart disease has been cut by half, an achievement associated with the decline in smoking and the increase in vascular risk drug therapy. These results indicate that these two primary prevention strategies have been effective at a population level, thanks to an appropriate balance between financial and health goals, something that should be left intact despite the current economic crisis. Future strategies ought to lay special stress on excessive body weight prevention.<\/p>\n","protected":false},"template":"","mots_cles":[],"class_list":["post-31022","resume","type-resume","status-publish","hentry"],"acf":{"adresse":"National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.","annee":"2014","mois":"2","numero":"4:2","page":"e004257","auteurs":[{"ID":31018,"post_author":"0","post_date":"2018-12-03 23:39:37","post_date_gmt":"2018-12-03 22:39:37","post_content":"","post_title":"Maria Jos\u00e9 Medrano","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"maria-jose-medrano","to_ping":"","pinged":"","post_modified":"2018-12-03 23:39:37","post_modified_gmt":"2018-12-03 22:39:37","post_content_filtered":"","post_parent":0,"guid":"https:\/\/aprifel-pp.mentalworks.biz\/fr\/auteur\/maria-jose-medrano\/","menu_order":0,"post_type":"auteur_resume","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":31019,"post_author":"0","post_date":"2018-12-03 23:39:38","post_date_gmt":"2018-12-03 22:39:38","post_content":"","post_title":"Enrique Alcalde-Cabero","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"enrique-alcalde-cabero","to_ping":"","pinged":"","post_modified":"2018-12-03 23:39:38","post_modified_gmt":"2018-12-03 22:39:38","post_content_filtered":"","post_parent":0,"guid":"https:\/\/aprifel-pp.mentalworks.biz\/fr\/auteur\/enrique-alcalde-cabero\/","menu_order":0,"post_type":"auteur_resume","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":31020,"post_author":"0","post_date":"2018-12-03 23:39:38","post_date_gmt":"2018-12-03 22:39:38","post_content":"","post_title":"Cristina Ortiz","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"cristina-ortiz","to_ping":"","pinged":"","post_modified":"2018-12-03 23:39:38","post_modified_gmt":"2018-12-03 22:39:38","post_content_filtered":"","post_parent":0,"guid":"https:\/\/aprifel-pp.mentalworks.biz\/fr\/auteur\/cristina-ortiz\/","menu_order":0,"post_type":"auteur_resume","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":31021,"post_author":"0","post_date":"2018-12-03 23:39:39","post_date_gmt":"2018-12-03 22:39:39","post_content":"","post_title":"Inaki Galan","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"inaki-galan","to_ping":"","pinged":"","post_modified":"2018-12-03 23:39:39","post_modified_gmt":"2018-12-03 22:39:39","post_content_filtered":"","post_parent":0,"guid":"https:\/\/aprifel-pp.mentalworks.biz\/fr\/auteur\/inaki-galan\/","menu_order":0,"post_type":"auteur_resume","post_mime_type":"","comment_count":"0","filter":"raw"}],"sources":[{"ID":2635,"post_author":"0","post_date":"2018-12-03 16:57:37","post_date_gmt":"2018-12-03 15:57:37","post_content":"","post_title":"BMJ open","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"bmj-open","to_ping":"","pinged":"","post_modified":"2018-12-03 16:57:37","post_modified_gmt":"2018-12-03 15:57:37","post_content_filtered":"","post_parent":0,"guid":"https:\/\/aprifel-pp.mentalworks.biz\/fr\/source\/bmj-open\/","menu_order":0,"post_type":"source","post_mime_type":"","comment_count":"0","filter":"raw"}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v23.6 (Yoast SEO v23.6) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Effect of cardiovascular prevention strategies on incident coronary disease hospitalisation rates in Spain; 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