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Drug Use for Secondary Prevention of Cardiovascular Diseases in Golestan, Iran: Results From the Golestan Cohort Study Pubmed



Nalini M1, 2 ; Sepanlou SG1 ; Pourshams A1, 3 ; Poustchi H1, 3 ; Sharafkhah M1, 4 ; Bahrami H5 ; Kamangar F3, 6 ; Malekzadeh R1, 3
Authors
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Authors Affiliations
  1. 1. Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  3. 3. Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  6. 6. Department of Biology, School of Computer, Natural Sciences, Morgan State University, Baltimore, MD, United States

Source: Archives of Iranian medicine Published:2018


Abstract

BACKGROUND: Little is known about secondary prevention of cardiovascular diseases, using cardio-protective drugs, in the community-level, especially in low- and middle-income countries. We aimed to assess main drug use and its predictors in Northeast of Iran. METHODS: This is a cross-sectional analysis on the Golestan Cohort Study data (2004-2008) with 50 045 participants. We assessed drug use in those with a history of ischemic heart disease (IHD) or stroke, recorded by face-to-face interviews. We explored drug use predictors (i.e., age, gender, wealth, education, residency, smoking, body mass index, physical activity, hypertension, and diabetes) through multivariable logistic regression. RESULTS: A total of 3371 (6.7%) participants (56.7 ± 9.0 years, 58.1% female) reported a history of IHD, stroke or both. Median duration since diagnosis was 3.14 years (IQR: 1.25-6.30). Rates of using anti-platelets, statins, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and beta-blockers were 28.8% (95% CI: 27.3-30.3), 5.4 (4.7-6.2), 15.7 (14.5-17.0), and 40.6 (38.9-42.3), respectively. About 43% (41 - 45) of patients did not use any protective drugs. Use of ≥ three drugs was only 7.3% (6.6-8.2). Indicators of ≥1 drug use were: older age (OR for ≥60 vs. <50: 1.37), high wealth score (fifth vs first quintile: 1.60), literacy (1.56), city dwelling (1.32), body mass index (<18.5 and ≥30 vs. 25-29: 0.55 and 1.25, respectively), physical activity (third vs. first tertile: 0.64), hypertension (3.47), and diabetes (1.29); (all P < 0.05). CONCLUSION: Drug use after IHD or stroke is low in Northeast of Iran. Comprehensive efforts to promote secondary prevention are urgently needed. © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, prov