Large Domestic Population Study: Exploring the Status of Secondary Prevention of Cardiovascular Disease in China

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Cardiovascular disease (CVD), especially ischemic heart disease (IHD) and ischemic stroke (IS), is the leading cause of death for our residents.Cardiovascular disease secondary prevention therapies, such as aspirin, beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), and statins, can reduce cardiovascular disease mortality.Therefore, ensuring widespread use of secondary prevention therapies is critical to reducing the burden of CVD in China.Recently, a study published in the journal HEART reported the current use of secondary preventive drugs in patients with IHD and / or IS in the Chinese community.
Research Methodology Based on the Chinese Patient-Centric Cardiac Event Million Person Assessment Project, which selected 2,613,035 ages in 35,857 communities in 31 provinces in mainland China from September 2014 to November 2018-Participants between the ages of 75.Researchers measured blood pressure, lipids, blood sugar, height, and weight for each participant.Hypertension is defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or use of antihypertensive drugs.Normal weight is defined as 18.5 ≤ BMI ≤ 23.9 kg / m2, low weight is defined as BMI <18.5 kg / m2, overweight is defined as 24.0 ≤ BMI ≤ 27.9 kg / m2, and obesity is defined as BMI ≥ 28.0 kg / m2.Standardized face-to-face interviews were conducted by trained personnel to gather relevant information about participants, their IHD or IS medical history, and medication use.The researchers used the Cloper-Pearson method to describe the overall and population subgroups (such as age, gender, and degree of urbanization) to determine the use of antiplatelet drugs or statins, and used a multivariate mixture model and logit-linkThe association between individual characteristics and secondary preventive drug use was assessed.Among the 2,613,035 participants, 2.9% (74,830) reported a history of IHD and / or IS, and the use of antiplatelet or statin drugs was 34.2% (Table 1).IHD patients use secondary prevention drugs more than IS patients (the ratio of either of the two drugs is 40.4% and 29.0%, the proportion of antiplatelet drugs is 37.4% and 26.6%, and the statins are 14.6% And 8.2%, the proportion of both drugs is 11.6% and 5.8%).The use of secondary preventive drugs increased with age (from 19.2% at 35-39 years to 37.3% at 70-75 years, p <0.001).Men used secondary prevention drugs more often than women (37.9% vs 30.4%, p <0.001).The use of antiplatelet drugs or statins was higher in urban areas than in rural areas (35.9% vs 32.9%, p <0.001).The proportion of patients with higher education levels and family income who used secondary preventive drugs was slightly higher (p <0.001).The proportion of patients with medical insurance using drugs was slightly higher than without medical insurance, but the difference was not statistically significant (34.3% vs 29.1%, p = 0.07).Patients with a previous history of hypertension (39.1% vs 28.7%, p <0.001) or diabetes (41.1% vs 32.7%, p <0.001) had significantly higher drug use rates.Patients diagnosed with CVD within 2 years (34.9%) had slightly higher drug use than patients diagnosed 2 years or earlier (33.7% in 2-7 years; 33.8% in> 7 years, p = 0.07).In a subgroup of 1,530,408 patients, defined by all possible permutations of 16 individual characteristics, the use of secondary preventive drugs varied widely (8.4% –60.6%).Multivariate analysis showed that the use of secondary prevention drugs was lower in patients who were younger, women, smokers, drinkers, had no history of hypertension or diabetes, and had been diagnosed with CVD for more than 2 years.
Conclusion In summary, in IHD and / or IS patients, about one-third of patients take antiplatelet or statins, and 1 in 12 patients take both drugs at the same time.The use of antiplatelet drugs and statins is low in all subgroups, especially among younger, female, educated, or low-income families.Improving the level of secondary prevention of cardiovascular disease in China requires scalable, targeted, and effective interventions.The above content is only authorized for exclusive use by, please do not reprint without the authorization of the copyright party.


The author ouyangshaoxia