Up-beat UK: a programme of research into the relationship between coronary heart disease and depression in primary care patients.

Coronary heart disease and depression are both common health problems and by 2020 will be the two leading causes of disability worldwide. Depression has been found to be more common in patients with coronary heart disease but the nature of this relationship is uncertain. In the United Kingdom general practitioners are now being remunerated for case-finding for depression in patients with coronary heart disease, however it is unclear how general practitioners should manage these patients. We aim to explore the relationship between coronary heart disease and depression in a primary care population and to develop an intervention for patients with coronary heart disease and depression

Natriuretic peptides and integrated risk assessment for cardiovascular disease. an individual-participant-data meta-analysis

BACKGROUND: Guidelines for primary prevention of cardiovascular diseases focus on prediction of coronary heart disease and stroke. We assessed whether or not measurement of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration could enable a more integrated approach than at present by predicting heart failure and enhancing coronary heart disease and stroke risk assessment. METHODS: In this individual-participant-data meta-analysis, we generated and harmonised individual-participant data from relevant prospective studies via both de-novo NT-proBNP concentration measurement of stored samples and collection of data from studies identified through a systematic search of the literature (PubMed, Scientific Citation Index Expanded, and Embase) for articles published up to Sept 4, 2014, using search terms related to natriuretic peptide family members and the primary outcomes, with no language restrictions. We calculated risk ratios and measures of risk discrimination and reclassification across predicted 10 year risk categories (ie, <5%, 5% to <7·5%, and ≥7·5%), adding assessment of NT-proBNP concentration to that of conventional risk factors (ie, age, sex, smoking status, systolic blood pressure, history of diabetes, and total and HDL cholesterol concentrations). Primary outcomes were the combination of coronary heart disease and stroke, and the combination of coronary heart disease, stroke, and heart failure. FINDINGS: We recorded 5500 coronary heart disease, 4002 stroke, and 2212 heart failure outcomes among 95 617 participants without a history of cardiovascular disease in 40 prospective studies. Risk ratios (for a comparison of the top third vs bottom third of NT-proBNP concentrations, adjusted for conventional risk factors) were 1·76 (95% CI 1·56-1·98) for the combination of coronary heart disease and stroke and 2·00 (1·77-2·26) for the combination of coronary heart disease, stroke, and heart failure. Addition of information about NT-proBNP concentration to a model containing conventional risk factors was associated with a C-index increase of 0·012 (0·010-0·014) and a net reclassification improvement of 0·027 (0·019-0·036) for the combination of coronary heart disease and stroke and a C-index increase of 0·019 (0·016-0·022) and a net reclassification improvement of 0·028 (0·019-0·038) for the combination of coronary heart disease, stroke, and heart failure. INTERPRETATION: In people without baseline cardiovascular disease, NT-proBNP concentration assessment strongly predicted first-onset heart failure and augmented coronary heart disease and stroke prediction, suggesting that NT-proBNP concentration assessment could be used to integrate heart failure into cardiovascular disease primary prevention

Women, men and coronary heart disease: a review of the qualitative literature

Aim. This paper presents a review of the qualitative literature which examines the experiences of patients with coronary heart disease. The paper also assesses whether the experiences of both female and male patients are reflected in the literature and summarizes key themes. Background. Understanding patients' experiences of their illness is important for coronary heart disease prevention and education. Qualitative methods are particularly suited to eliciting patients' detailed understandings and perceptions of illness. As much previous research has been 'gender neutral', this review pays particular attention to gender. Methods. Published papers from 60 qualitative studies were identified for the review through searches in MEDLINE, EMBASE, CINAHL, PREMEDLINE, PsychINFO, Social Sciences Citation Index and Web of Science using keywords related to coronary heart disease. Findings. Early qualitative studies of patients with coronary heart disease were conducted almost exclusively with men, and tended to generalize from 'male' experience to 'human' experience. By the late 1990s this pattern had changed, with the majority of studies including women and many being conducted with solely female samples. However, many studies that include both male and female coronary heart disease patients still do not have a specific gender focus. Key themes in the literature include interpreting symptoms and seeking help, belief about coronary 'candidates' and relationships with health professionals. The influence of social roles is important: many female patients have difficulties reconciling family responsibilities and medical advice, while male patients worry about being absent from work. Conclusions. There is a need for studies that compare the experiences of men and women. There is also an urgent need for work that takes masculinity and gender roles into account when exploring the experiences of men with coronary heart disease

A Conceptual Model: The Impact of Sociodemographic on Coronary Heart Disease

The paper aims to examine the conceptual model on the impact of sociodemographic towards coronary heart disease. There is still limited study on the association between cost of living particularly the cost of food and housing and its impact on coronary heart disease. Therefore, this study incorporates five essential sociodemographic attributes namely, cost of food, children education cost, housing cost, smoking habit and gender. The study provides greater understanding on how the cost of living and lifestyle may give impact to coronary heart disease. It may provide the awareness among the regulators as the society faces burden of high cost of living. The burden may threaten the Malaysians quality of life particularly the lower income group

Hubungan Kebiasaan Konsumsi Makanan Cepat Saji Dengan Kejadian Penyakit Jantung Koroner Pada Pasien Rawat Jalan Di RSUD Dr. Moewardi

Introduction: Coronary heart disease is one of diseases that requires special attention. Coronary heart disease is the leading cause of death in Indonesia, ranked first with 11.06% mortality. Coronary heart disease is caused by the process of atherosclerosis which is started from accumulation of cholesterol. One of factors that affects coronary heart disease is fast food consumption, which contains high fat, high-energy, high sodium, and low fiber. Purpose: This research aimed to understand the relationship between fast food consumption and coronary heart disease in outpatients of Dr. Moewardi Hospital. Research method: This research was an observational research with cross-sectional design. Sampling method used consecutive sampling. The subjects were 37 patients of coronary heart disease, aged 40-65 years old. Fast food consumption data were collected through interview using questionnaire and food-frequency questionnaire. Coronary heart disease data were obtained from patients‘ medical record. This research used statistical tests of Fisher's Exact. Results: Among patients who often consumed fast food, 76% of them had coronary heart disease. Meanwhile, those who rarely consumed fast food, 66,7% of them did not have coronary heart disease. There was a correlation between fast food consumption and coronary heart disease (p = 0,027). Conclusion: There was a relationship between fast food consumption and coronary heart disease in outpatients of Dr. Moewardi Hospital

Relations between lipoprotein(a) concentrations, LPA genetic variants, and the risk of mortality in patients with established coronary heart disease: a molecular and genetic association study

Background: Lipoprotein(a) concentrations in plasma are associated with cardiovascular risk in the general population. Whether lipoprotein(a) concentrations or LPA genetic variants predict long-term mortality in patients with established coronary heart disease remains less clear. Methods: We obtained data from 3313 patients with established coronary heart disease in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. We tested associations of tertiles of lipoprotein(a) concentration in plasma and two LPA single-nucleotide polymorphisms ([SNPs] rs10455872 and rs3798220) with all-cause mortality and cardiovascular mortality by Cox regression analysis and with severity of disease by generalised linear modelling, with and without adjustment for age, sex, diabetes diagnosis, systolic blood pressure, BMI, smoking status, estimated glomerular filtration rate, LDL-cholesterol concentration, and use of lipid-lowering therapy. Results for plasma lipoprotein(a) concentrations were validated in five independent studies involving 10 195 patients with established coronary heart disease. Results for genetic associations were replicated through large-scale collaborative analysis in the GENIUS-CHD consortium, comprising 106 353 patients with established coronary heart disease and 19 332 deaths in 22 studies or cohorts. Findings: The median follow-up was 9·9 years. Increased severity of coronary heart disease was associated with lipoprotein(a) concentrations in plasma in the highest tertile (adjusted hazard radio [HR] 1·44, 95% CI 1·14–1·83) and the presence of either LPA SNP (1·88, 1·40–2·53). No associations were found in LURIC with all-cause mortality (highest tertile of lipoprotein(a) concentration in plasma 0·95, 0·81–1·11 and either LPA SNP 1·10, 0·92–1·31) or cardiovascular mortality (0·99, 0·81–1·2 and 1·13, 0·90–1·40, respectively) or in the validation studies. Interpretation: In patients with prevalent coronary heart disease, lipoprotein(a) concentrations and genetic variants showed no associations with mortality. We conclude that these variables are not useful risk factors to measure to predict progression to death after coronary heart disease is established. Funding: Seventh Framework Programme for Research and Technical Development (AtheroRemo and RiskyCAD), INTERREG IV Oberrhein Programme, Deutsche Nierenstiftung, Else-Kroener Fresenius Foundation, Deutsche Stiftung für Herzforschung, Deutsche Forschungsgemeinschaft, Saarland University, German Federal Ministry of Education and Research, Willy Robert Pitzer Foundation, and Waldburg-Zeil Clinics Isny

Pola Komunikasi Keluarga untuk Proses Pendampingan dan Penyembuhan Penyakit Jantung Koroner

Communication has a very important process in the healing process of coronary heart disease. The mortality rate due to coronary heart from year to year increase due to unsuccessful medical treatment coupled with poor family communication quality as part of non medical treatment. Improper communication process such as poor companion in doing his job. Wife who can not wait to face the husband, child who does not care, the patient has no room to tell what he felt, it could be the cause of non medical treatment failure in the healing of coronary heart patients. As for the background of this writing because the cause of Death Due to Heart Disease in the World (WHO, 2005) Indonesia: 59.5% Death Due to Non Communicable Diseases, Including Heart In Indonesia, as a developing country is still struggling with various health problems. This is reinforced by data obtained in 2007, the rate of death from heart disease and non-communicable in 1995 amounted to 41.7% increased to 59.5% in 2007. And also researchers want to know how the assistance and how the communication that took place between families and people with coronary heart disease. Using a qualitative approach, this study aims to find out "Patterns of Family Communication for the Mentoring and Healing Process of Coronary Heart Disease". This research uses an interpretive paradigm with phenomenology method. The subjects of this study were two families, each of whom had a family with coronary heart disease. Theories used in this study were Family Communication, Relational Maintenance Theory, Self Disclosure, and Conflict. The results showed that family one and two showed an intense communication between family members and with patients with coronary heart disease. Companion of patients with coronary heart disease from each family is always trying to support the healing of patients with coronary heart disease.Penelitian concluded that two families who become the object of research have the same pattern of communication balance where the pattern of communication that exists between husband, wife, child is very open, honest, direct and free. This study revealed that patients with coronary heart disease is not always unable to control himself, based on research conducted dissent that occurred did not cause conflict in the family Family communication in the healing assistance of patients with coronary heart disease in addition to used to make communication in the family well preserved, also used to provide assistance in healing people with coronary heart disease. Patients with coronary heart disease with companion coronary heart disease patients in this study shows are on the perspective of Open in Johari Window. Where is that information known to people with coronary heart disease is also known by a companion or a family member known to people with coronary heart disease is also known by the companion or family members who care. Families who care for people with coronary heart disease always try to be in addition to patients with coronary heart disease

Quantitative and Qualitative Research on the Fear of Recurrence and the Belief in Prevention of Recurrence in Elderly Patients with Coronary Heart Disease

Objective: To explore the fear of recurrence and the belief in prevention of recurrence in elderly patients with coronary heart disease. Methods: A total of 178 elderly patients with coronary heart disease were included, and quantitative and qualitative research methods were used to explore the fear of recurrence and the belief in prevention of recurrence in elderly patients with coronary heart disease. The quantitative research tool was a self-made fear of coronary heart disease recurrence questionnaire; the qualitative research was guided by the phenomenological method, semi-structured in-depth interviews with 11 elderly patients with coronary heart disease, and the data were collected by recording, and the Colaizzi method was used to analyze the data. Results Elderly patients with coronary heart disease were afraid of recurrence; they knew the etiology of coronary heart disease, but the controllable rate of the cause and effect was extremely low. Conclusion: Due to the belief in fatalism and the lack of control over the etiology of coronary heart disease, elderly patients with coronary heart disease are afraid of recurrence