Database : MedCarib
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Id: 18108
Author: The University of the WestIndies(aut); Critchley, J(aut); Samuels, TA; Rose, AMC; Capewell, S(aut); OÆFlaherty, M(aut); Unwin, N(aut).
Title: Explaining the trends in coronary heart disease mortality in Barbados: 1990û2012
Source: West Indian med. j;65(Supp. 3):[54], 2016.
Language: en.
Conference: Present in: 61st Annual CARPHA Health Research Conference, Providenciales, June 23-25, 2016.
Abstract: OBJECTIVE: To describe the relative contributions of medical treatments and major cardiovascular risk factors to the decline in coronary heart disease (CHD) mortality from1990 to 2012 in Barbados. SUBJECTS AND METHODS: We used the IMPACT CHD mortality model to estimate the effect of improvement in uptake or efficacy of medical/surgical treatments, versus changes in major CHD risk factors on mortality trends. We obtained death data from the World Health Organization(WHO) mortality database and population denominators, stratified by age and gender from the Barbados Statistical Service. Cardiovascular risk factors and treatment data were obtained from published studies, population-based risk factor surveys, BarbadosÆ national myocardial infarction registry and retrospective chart reviews. RESULTS: In 1990, the age-standardized CHD mortality rate was 109.5 per 100 000, falling to 55.3 in 2012, representing a 46.1% decline in CHD deaths. This resulted in139 fewer deaths observed in 2012 versus the number expected had the rate remained as in 1990. The model indicated that 61% (n = 84) of these deaths were prevented or postponed (DPPs) because of implementation of treatment. Changes in risk factors accounted for 14% of the overall decline (19 DPPs). Improvements in cholesterol, physical inactivity, smoking and fruit/vegetable intake accounted for 51 DPPs; worsening systolic bloodpressure, diabetes and obesity levels were responsible for 32 additional deaths in 2012. CONCLUSIONS: Treatments accounted for approximately two-thirds of the mortality reduction. More effective prevention policies are urgently needed.
Responsable: TT2.1 - Library
TT5; W1, WE389


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Id: 17687
Author: Ezenwaka, C. E. (aut); Nwagbara, E. (aut); Seales, D. (aut); Okali, F. (aut); Hussaini, S. (aut); Raja, B. (aut); Jones-LeCointe, A. (aut); Sell, H. (aut); Avci, H. (aut); Eckel, J. (aut).
Title: Prediction of 10-year coronary heart disease risk in Caribbean type 2 diabetic patients using the UKPDS risk engine
Source: International journal of cardiology;132(3):348-353, Mar. 2009. tab.
Language: en.
Abstract: OBJECTIVE: Primary prevention of Coronary Heart Disease (CHD) in diabetic patients should be based on absolute CHD risk calculation. This study was aimed to determine the levels of 10-year CHD risk in Caribbean type 2 diabetic patients using the diabetes specific United Kingdom Prospective Diabetes Study (UKPDS) risk engine calculator. SUBJECTS AND METHODS: Three hundred and twenty-five (106 males, 219 females) type 2 diabetic patients resident in two Caribbean Islands of Tobago and Trinidad met the UKPDS risk engine inclusion criteria. Records of their sex, age, ethnicity, smoking habit, diabetes duration, systolic blood pressure, total cholesterol, HDL-cholesterol and glycated haemoglobin were entered into the UKPDS risk engine calculator programme and the absolute 10-year CHD and stroke risk levels were computed. The 10-year CHD and stroke risks were statistically stratified into <15%, 15-30% and >30% CHD risk levels and differences between patients of African and Asian-Indian origin were compared. RESULTS: In comparison with patients in Tobago, type 2 diabetic patients in Trinidad, irrespective of gender, had higher proportion of 10-year CHD risk (10.4 vs. 23.6%, P<0.001) whereas the overall 10-year stroke risk prediction was higher in patients resident in Tobago (16.9 vs. 11.4%, P<0.001). Ethnicity-based analysis revealed that irrespective of gender, higher proportion of patients of Indian origin scored >30% of absolute 10-year CHD risk compared with patients of African descent (3.2 vs. 28.2%, P<0.001). CONCLUSIONS: The results of the study identified diabetic patients resident in Trinidad and patients of Indian origin as the most vulnerable groups for CHD. These groups of diabetic patients should have priority in primary or secondary prevention of coronary heart disease.
Responsable: TT5 - Médical Sciences Library


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Id: 17686
Author: Ezenwaka, C. E. (aut); Nwagbara, E. (aut); Seales, D. (aut); Okali, F. (aut); Sell, H. (aut); Eckel, J. (aut).
Title: Insulin resistance, leptin and monocyte chemotactic protein-1 levels in diabetic and non-diabetic Afro-Caribbean subjects
Source: Archives of physiology and biochemistry;115(1):22-27, Feb. 2009. tab.
Language: en.
Abstract: AIM: To determine how the levels of leptin and monocyte chemotactic protein-1 (MCP-1) are associated with insulin resistance (IR) in obese, non-obese, diabetic and non-diabetic subjects. METHODS: 112 type 2 diabetics and 43 non-diabetics were studied fasting. Anthropometric indices were measured and glucose, insulin, leptin and MCP-1 were measured in blood. IR was calculated. RESULTS: MCP-1 level was significantly higher in diabetics than non-diabetics irrespective of gender (p < 0.05). Irrespective of diabetes status, the serum leptin concentration was significantly higher (p < 0.05) in obese and females subjects than in non-obese and male subjects respectively. There were no significant correlations between IR and MCP-1 or leptin in all subgroups of subjects studied. General linear modelling analysis showed that only diabetes state significantly predicted MCP-1 levels (p < 0.05) whereas non of the factors predicted leptin levels (p > 0.05). CONCLUSION: Routine measurement of leptin and MCP-1 would be potentially useful in assessment of patients for the metabolic syndrome or coronary heart disease especially in black population.
Responsable: TT5 - Médical Sciences Library


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Id: 17581
Author: Ezenwaka, C. E. (aut); Dimgba, A. (aut); Okali, F. (aut); Skinner, T. (aut); Extavour, R. (aut); Rodriguez, M. (aut); Jones-LeCointe, A. (aut).
Title: Self-monitoring of blood glucose improved glycemic control and the 10-year coronary heart disease risk profile of female type 2 diabetes patients in Trinidad and Tobago
Source: Nigerian journal of clinical practice;14(1):5, Jan-Mar. 2011. graf.
Language: en.
Abstract: BACKGROUND and AIM: The risk of death from coronary heart disease (CHD) in women with diabetes is more than three times that of non-diabetic women. We assessed the difference in CHD risk levels of Afro-Caribbean diabetic women provided with facilities for self-monitoring of blood glucose and their counterparts without such facilities. MATERIALS and METHODS: Forty-nine patients who never used gluco-meters were studied as intervention (23) and control (26) groups. The intervention group was trained on self-monitoring of blood glucose. At baseline, BP, anthropometric indices, and fasting blood glucose of all patients were measured. Subsequently, the intervention patients were provided with gluco-meters, testing strips, and advised to self-monitor fasting and postprandial blood glucose every other day for 6 months. CHD risk was determined with the United Kingdom Prospective Diabetes Study risk engine calculator. RESULTS: The age, duration of diagnosis of diabetes, BP, and anthropometric indices were similar in the two groups (all, P > 0.05). The majority of the patients were unemployed or retired with only primary education. After 3 months, the HbA 1c levels of the control patients did not change (8.3 ± 0.4% vs. 7.8 ± 0.4%, P > 0.05) whereas the HbA 1c levels of the intervention patients reduced significantly from the baseline at 3 (9.2 ± 0.4% vs. 7.4 ± 0.3%, P <0.001) and 6 (9.2 ± 0.4% vs. 7.3 ± 0.3%, P <0.001) months. The 10-year CHD risk level of the intervention group was remarkably reduced from the baseline level after 6 months (7.4 ± 1.3% vs. 4.5 ± 0.9%) of the study. CONCLUSION: Provision of facilities for self-monitoring of blood glucose in Afro-Caribbean women with type 2 diabetes improves both their glycemic control and CHD risk profile.
Responsable: TT5 - Médical Sciences Library


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Id: 17071
Author: Chinnock, Paul(ed).
Title: Diabetes: a Caribbean concern
Source: Caribbean Health;4(5):p.2, Oct. 2001.
Language: En.
Abstract: We have asked many doctors in the Caribbean which clinical conditions cause them the most concern. The three topics that have probably been mentioned most often are cardiovascular disease, diabetes, and asthma. Readers have asked us to carry more information on the management of these illnesses. Hypertension and asthma have already been the subject of special supplements in Caribbean Health. Now, in this issue of the journal we are pleased to be publishing a similar supplement devoted to diabetes (AU)
Responsable: TT5 - Médical Sciences Library
TT5; W1 CA787T


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Id: 16868
Author: Brann, S; Thomas, C; Chen, D; Williams, D; Merrit, L; Mootoo, N; Legall, C; Harewood, W; Ezeokoli, C; Penault, L.
Title: Some experimental coronary artery bypass grafting (CABG) to cardiac transplantation
Language: En.
Responsable: TT5 - Médical Sciences Library
TT5


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Id: 16492
Author: Miller, George J; Beckles, Gloria L. A; Alexis, Sunny D; Byam, Neville T. A; Price, S. G. L.
Title: Serum lipoproteins and susceptibility of men of Indian descent to coronary heart disease.
Source: Champs Fleurs; Faculty of Medical Sciences, The University of the West Indies; 1993. 4 p.
Language: En.
Responsable: TT5 - Médical Sciences Library
TT5; QU 95 S489 1993


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Id: 16175
Author: Miller, George J; Beckles, Gloria L. A; Maude, Gillian H; Carson, D. C; Alexis, Sunny D; Price, S. G. L; Byam, Neville T. A.
Title: Ethnicity and other characteristics predictive of coronary heart disease in a developing community: principal results of the St. James survey, Trinidad.
Source: London; International Epidemiological Association; 1989. 808-16 p. tab. , 4
Language: En.
Abstract: A ten-year community survey was undertaken to investigate the high coronary heart disease(CHD) incidence among people of Indian(South Asian) descent in Trinidad, West Indies. Of 2491 individuals aged 35-69 years, 2215(89 percent) were examined and 2069(83 percent) found to be clinically free of CHD at baseline> After exclusion of 71 of minority ethnic groups, 786 African, 598 Indian, 147 European 467 adults of Mixed descent were followed for CHD morbidity and mortality. In both sexes, adults of Indian descent had higher prevalences rates of diabetes mellitus, a low concentration of high-density lipoprotein (HDL) cholesterol, and recent abstinence from alcohol than other ethnic groups. Indian men also had larger skinfold thickness than other men. In participants free of CHD at entry, the age adjusted relative risk of a cardiac event believed due to CHD was at least twice as high in Indian men and women as in other ethnic groups. In men , blood pressure, diabetes mellitus and low-density lipoprotein (LDL) cholesterol concentration were positively and independently related to risk of CHD, whereas alcohol consumption and HDL cholesterol concentration were inversely associated with risk after allowing for age and ethnic group. The ethnic contrasts in CHD persisted when these characteristics were taken into account. In the smaller sample of women, only ethnic group was predictive of CHD as defined. The failure of point estimates of risk to explain the high CHD incidence in Indians calls for focus on age of onset and examination of other potential risk factors such as insulin concentration (AU)
Responsable: TT5 - Médical Sciences Library
TT5; WG 300 E84 1989


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Id: 16112
Author: Miller, George J; Beckles, Gloria L. A; Maude, Gillian H; Carson, D. C.
Title: Alcohol consumption: protection against coronary disease and risks to health.
Source: s.l; International Epidemiological Association; 1990. 923-30 p. , 4
Language: En.
Abstract: In a prospective cardiovascular study of 1341 Trinidadian men aged 35-69 years undertaken between 1977 and 1986, the baseline prevalence rates of cardiac and arterial disease and diabetes mellitus were increased in the 118(8.8 percent) who had been but were no longer regular drinkers. This finding suggested that awareness of these disorders was a discouragement to drinking alcohol. When this group and all with coronary heart disease (CHD) or diabetes at entry were excluded, a significant inverse trend was found between alcohol consumption in the week before recruitment and risk of CHD across the subsequent average follow-up of 7.5 years. Men who had taken between 5-14 drinks had about half the CHD risk of those who had had no alcohol, even after allowance for age, ethnicity, smoking, blood pressure and cholesterol concentration. The overall morbidity and mortality experience in this community indicated a protective effect of alcohol against CHD, but averse health consequences from multiple causes in drinkers who were alcohol dependent. (AU)
Responsable: TT5 - Médical Sciences Library
TT5; WG 300 A354 1990


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Id: 15918
Author: Miller, George J.
Title: Some recent advances in non-communicable diseases in the tropics. 3. Coronary heart disease and associated characteristics in a tropical developing community
Source: Trans R Soc Trop Med Hyg;85(3):332-5, May-June 1991.
Language: En.
Abstract: Vital statistics indicate that cardiovascular disorders are now major causes of morbidity and mortality in many Caribbean communities. in Trinidad and Tobago, for example, the death rate from myocardial infarction is now similar to that in the UK and USA. In a 10-year prospective survey of 1386 men aged 35 to 69 years at entry, who belonged to a defined community in Port-of-Spain, Trinidad, serum high-density (HDL) and low-density (LDL) lipoprotein cholesterol concentrations were very similar to those found by the same methods in Bristol, England. The age-adjusted incidence of first coronary heart disease (CHD) events in men clinically free of the disease at recruitment (per 1000 person-years) was 16.4 in those of European origin, and 2.4 in men of mixed descent (the contemporaneous figure for Bristol was about 12/1000 person-years). Serum HDL and LDL cholesterol concentrations were strong and independent predictors of CHD in Trinidad, as they are in temperate climes. With efective control of tropical infectious diseases, and adoption of western patterns of consumerism, tropical developing communities will rapidly acquire the CHD risk factor status once more or less exclusive to developed populations in more temperate climes. (AU)
Responsable: JM3.1 - Médical Library
JM3.1; RC960.R6



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