Each year, ≈795 000 individuals in the United States experience a stroke, of which 87% (690 000) are ischemic and 185 000 are recurrent.1 Approximately 240 000 individuals experience a transient ischemic attack (TIA) each year.2 The risk of recurrent stroke or TIA is high but can be mitiga...ted with appropriate secondary stroke prevention. In fact, cohort studies have shown a reduction in recurrent stroke and TIA rates in recent years as secondary stroke prevention strategies have improved.3,4 A meta-analysis of randomized controlled trials (RCTs) of secondary stroke prevention therapies published from 1960 to 2009 showed a reduction in annual stroke recurrence from 8.7% in the 1960s to 5.0% in the 2000s, with the reduction driven largely by improved blood pressure (BP) control and use of antiplatelet therapy.5 The changes may have been influenced by changes in diagnostic criteria and differing sensitivities of diagnostic tests over the years.
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Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc...ular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
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The American Heart Association and the American College of Cardiology are excited to provide a series of cardiovascular prevention guidelines for the assessment of cardiovascular risk, lifestyle modifications that reduce risk, management of elevated... blood cholesterol, and management of increased body weight in adults.
To support the implementation of these guidelines, the Pooled Cohort Equations CV Risk Calculator and additional Prevention Guideline Tools are available in the tools below as well as the AHA Guidelines On-the-Go Mobile App, found in the Apple Store and Google Play. Others may be developed and available in the near future.
The purpose of the ASCVD Risk Calculator is to estimate a patient’s 10-year ASCVD risk at an initial visit to establish a reference point. ACC/AHA guidelines recommend the use of the PCE as an important starting point, not as the final arbiter, for decision making in primary prevention of ASCVD.
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The increasing prevalence of childhood asthma in the developed world is a cause for concern. A so-called Western lifestyle has been the factor most commonly cited to explain this worrying increase in asthma prevalence. Early studies in a limited num...ber of African countries showed a very low rural prevalence of childhood asthma, especially where children lived according to a traditional lifestyle. These same studies showed that asthma was not uncommon in urbanized African children. There has been an
increasing tendency over the past 20 years for those in rural communities to move to the large urban centers. This article analyses the urban-rural differences and factors that influence the development of asthma in susceptible children.
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If your result shows you’re at high risk for type 2 diabetes, talk to your doctor about getting a simple blood sugar test to confirm it. Then, if you’re diagnosed with prediabetes, consider joining a lifestyle change program offered by the Natio...nal Diabetes Prevention Program (National DPP). This program is proven to cut the risk for type 2 diabetes in half.
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Type 2 diabetes mellitus (T2DM) is a chronic condition characterized by insulin resistance and an inability to properly regulate blood sugar levels. The two most important risk factors for T2DM are a family history of diabetes and obesity, though age, race, diet, and exercise level also impact risk.... Common symptoms include frequent urination, nerve damage, and dark skin patches. Treatment involves lifestyle changes like diet and exercise as well as medications like metformin, which improves insulin sensitivity and decreases glucose production in the liver. Patients are counseled on managing diabetes-related risks and provided support through organizations and groups.
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High blood pressure, or hypertension, is one of the most serious risks factors for death from heart diseases and strokes, responsible for 13% of all deaths globally. In South Africa more than 1 in 3 adults live with high blood pressure and it is responsible for 1 in every 2 strokes and 2 in every 5 ...heart attacks. High blood pressure is known as a 'silent killer' because there are rarely any symptoms or visible signs to warn that blood pressure is high. That is why more than 50% of people with high blood pressure are unaware of their condition. In some cases, typically with very high blood pressure, symptoms such as headaches, visual disturbances, nose bleeds, nausea, vomiting, facial flushing and sleepiness may be experienced. Do not wait for symptoms to appear. High blood pressure becomes more likely with older age, but anyone, no matter their age, gender, fitness level or lifestyle can develop high blood pressure. Blood pressure should be measured at least once every year, so don’t delay!
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The article "Cardiovascular Diseases" on Our World in Data provides an in-depth analysis of cardiovascular diseases (CVD), the leading cause of death globally. It examines CVD trends, such as the decline in mortality rates in high-income countries due to improved healthcare and ...e-to-highlight medbox">lifestyle changes, while low- and middle-income countries experience rising CVD burdens. The article highlights major risk factors, including high blood pressure, obesity, smoking, and poor diet. It emphasizes the importance of preventive measures and access to treatment to reduce global disparities in CVD outcomes. The data-driven approach uses visualizations to illustrate the global impact and distribution of CVD.
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The "Prediabetes Risk Test" is a tool designed to help individuals assess their risk for prediabetes and type 2 diabetes. The test uses a point-based system with questions about age, gender, family history of diabetes, history of high blood pressure, physical activity level, and weight category. Bas...ed on the total score, individuals with a score of 5 or higher are at an increased risk of prediabetes, meaning their blood sugar levels may be elevated but not yet high enough to be classified as type 2 diabetes. The test encourages individuals with a high score to consult a doctor for further testing and suggests lifestyle changes as a preventive measure. Special risk considerations are provided for certain ethnic groups, such as African American, Hispanic/Latino, American Indian, Alaska Native, Asian American, and Pacific Islander populations.
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Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and 1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertia...ry education for fathers (adjusted OR (95% CI); 2.32 (1.71–3.16)) and mothers (1.85 (1.38–2.48)); area of residence at birth, with children born in a small town or in the city having an increased asthma risk compared to schoolchildren born in rural areas (2.16 (1.60–2.92)) and (2.79 (1.79–4.35)), respectively; father’s and mother’s history of asthma; children’s own allergic conditions; atopy; and cooking on gas/electricity. In conclusion, asthma was associated with a strong rural-town-city risk gradient, higher parental socio-economic status and urbanicity. This work provides the basis for future studies to identify specific environmental/lifestyle factors responsible for increasing asthma risk among children in urban areas in LMICs.
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A long and healthy life for all South Africans
The health of the people and health services are in crisis, and together as partners this plan commits us to strategies aimed at achieving our goal of:
Strengthened primary ...te-to-highlight medbox">health care for all, and improved service delivery for the rural majority and the urban disadvantaged.
Original file: 67 MB
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This report considers how to integrate health into urban planning, investments, and policy decisions, so as to support the implementation and achievement of the goals and objectives of the New Urban Agenda.
No education system is effective unless it promotes the health and well-being of its students, staff and community. These strong links have never been more visible and compelling than in the context of the COVID-19 pandemic. Towards making every sch...ool a health-promoting school: Let’s start with a shared vision based on the standards and indicators presented in this publication.
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