WEEK 4: Epidemiology of coronary heart diseases Flashcards
Outline the diseases caused by CHD/ IHD.
What do mortality from CHD results from?
CHD/IHD»_space;> stable angina, acute coronary syndrome (ACS), ischemic myocardial infarction
- Mortality from CHD results from CAD
- Epidemiology refers to the distribution and determinants of a disease or a health-related event in specified populations and the application of such knowledge for the control and prevention strategies.
What is epidemiology?
Epidemiology refers to the distribution and determinants of a disease or a health-related event in specified populations and the application of such knowledge for the control and prevention strategies.
Discuss the Global epidemiology of coronary heart disease (CHD)
CHD is the worlds biggest killer
* It remains to be the top leading cause of death since 2000
* It accounts for 16% of all deaths globally (approx. 8 864 000)
* Largest increase in deaths 2000 2019, more than 2 Million
* 244.1 million people with IHD (141 male:103.1 female)
* IHD mortality rate 112.37 per 100 000
* Highest mortality in N. Africa, Middle East, Eastern Europe + Central Asia
What are the top 5 leading causes of death globally.
- IHD
2.Stoke - COPD
- Lower respiratory infections
- Neonatal conditions
What are the top 5 leading causes of death in low-income countries?
- Neonatal conditions
2.Lower respiratory infections - IHD
- Stroke
- Diarrheal diseases
What are the top 5 leading causes of death in middle-income countries?
- IHD
- Stroke
- COPD
- Tracheal, bronchial and lung cancers
- Lower respiratory tract infections
State the leading causes of death in Botswana.
- HIV& AIDS
- IHD
- Stroke
- Diabetes
- Neonatal conditions
- TB
- Road accidents
8 Diarrheal diseases - Interpersonal violence
The concept of risk factors in CHD was first coined by the Framingham heart study.
* Behavioral versus non-behavioral risk factors
* Modifiable versus non-modifiable risk factors
Outline the major modifiable risk factors of CHD.
Major modifiable risk factors
- High blood pressure
- Abnormal blood lipids
- Tobacco use
- Physical inactivity
- Obesity
- Unhealthy diet
- Diabetes mellitus
Outline the non-modifiable risk factors of CHD.
- Age
- Heredity or family history
- Gender
- Ethnicity or race
Outline the Other modifiable risk factors.
- Low socioeconomic status
- Mental ill health (depression)
- Psychosocial stress
- Heavy alcohol use
- Use of certain medication
- Lipoprotein(a)
Outline” Novel” risk factors for CHD.
- Excess homocysteine in blood
- Inflammatory markers (C-reactive protein)
- Abnormal blood coagulation (elevated
blood levels of fibrinogen)
Outline the 3 measures of risk.
Odds ratio
Relative risk
Population attributable risk
Define odd ratio.
State the formula for Odd ratio.
OR is a measure of association between an
exposure (risk factor) and an outcome
- OR– approximation for case control study
[ad/bc] - OR= odds of the event in exposed group/odds
of the event in non-exposed group
Note: If given smokers and non-smokers: You calculate the odd ratio for each group independently and then find the odd ratio of the two odd ratios for the independent groups.
- OR= (17/83)/ (1/99) =0.205/0.01=20.5
Define relative risk.
State the formula for relative risk.
How many times would exposure to a factor increase the incidence in an individual.
Incidence among exposed / Incidence among the unexposed
NOTE: You find the positive incidence over the total for each group separately and then find the incidence of the two groups.
Define Population attributable risk.
State the formula for Population attributable risk.
How many times would exposure to a factor increase the incidence rate of a group.
Population attributable risk [PAR]= Ir - Io
* The rate of the disease in the study population minus the rate in the unexposed group
- Estimates the excess rate of disease in the total study population of exposed and non-exposed individuals that is attributable to the
exposure.
Incidence among exposed - Incidence among the unexposed
NOTE: You find the positive incidence over the total for each group separately and then find the incidence of the two groups by subtracting them from each other.
