Sức khoẻ tim mạch cộng đồng cập nhật về các biện pháp dự phòng

15th Vietnam National Congress of Cardiology Hanoi, October 2016 POPULATION CARDIOVASCULAR HEALTH – Update on Prevention Professor Christopher Reid, Co-Director CCRE Therapeutics School of Public Health & Preventive Medicine, Monash University Director, Curtin Centre of Clinical Research & Education School of Public Health, Curtin University Faculty Disclosures • No Disclosures CM Reid has received research support from Astra Zeneca, AMRAD, Bayer, BMS, Boehringer-Ingelheim, Sanofi Aventis, Servier, National Heart Foundation, National Health and Medical Research Council of Australia (Research Fellowship, Project and Program grants), and the US National Institutes of Health NIL related to this presentation Population Cardiovascular Health WHO, 2016 Population Cardiovascular Health Projections of global mortality and burden of disease from 2002 to 2030, WHO Report 2010 Burden of disease by broad cause group 1990 – 2020 in Developing Countries* % 50 1990 2020 25 *DALY = Disability adjusted life-year Communicable diseases, maternal and perinatal conditions and nutritional deficiencies Injuries Noncommunicable conditions Source: WHO, Evidence, Information and Policy, 2000 Epidemiological Transition Epidemiological transition interaction between pattern of health and disease and  Populationeconomic Approach& social determinants and “their demographic, consequences” Pestilence & Receding Degenerative & Famine Pandemics Man-made Economic Growth Chronic diseases  Infectious diseases Globalisation & Urbanisation Tobacco Advertising - CAMBODIA Mc Globalisation - CHINA Coca-colarisation INDIA Life Expectancy at Birth - 2016 Population Ageing as a driver of CVD “Based on population projections by the Australian Bureau of Statistics, there will be 9.6 million people aged 65 and over and 1.9 million people aged 85 and over by 2064” AIHW, 2016 % 65 and over 10 Population Ageing as a driver of CVD 11 Strategies for Prevention 17 Strategies for Prevention 18 Populations Surveillance of Risk Factors Quality risk factor surveillance data is possible in even the least resourced countries 19 Best buys for Population prevention and control of CVD Majority are public policy based interventions 20 Weight Loss in Overweight / Obese Individuals 21 Physical Inactivity 22 Prevention Works - Physical Activity Vigorous exercise* Walking P=0.008 P=0.004 Relative Risk of CHD Relative Risk of CHD Women’s Health Initiative Observational Study 1.0 0.8 0.6 0.4 0.2 0.0 1.0 0.8 0.6 0.4 0.2 0.0 5 Quintiles of activity (MET-hour/week**) *Includes aerobics, aerobic dancing, jogging, tennis, and swimming laps CHD=Coronary heart disease 23 Lifestyle Modification Diabetes Prevention Program (DPP) 3,234 patients with elevated fasting and post-load glucose levels randomized to placebo, metformin (850 mg bid), or lifestyle modification* for years Percent developing diabetes Lifestyle (n=1079, p