Üçüncü Basamak Hastanelerinde Koroner Arter Hastalığı Olan Hastalarda Konvansiyonel Risk Faktörleri Üzerine Çalışma, Pokhara, Nepal

Yıl 2019, , 183 - 199, 30.06.2019

Bijaya Adhıkarı , Robhash Kusam Subedı Chacchu Gopal Saha

https://doi.org/10.26453/otjhs.464534

Öz

Koroner arter hastalığı (KAH)
son birkaç yılda gelişmiş dünyada kayda değer bir düşüş göstermiştir, ancak
gelişmekte olan dünyada özellikle Güney Asya'da endişe verici bir artış
göstermiştir. Bu çalışmanın amacı, dört konvansiyonel risk faktörünü araştırmaktı:
Nepal'deki Pokhara vadisinin üçüncü basamak hastanelerinde koroner kalp
hastalığı olan hastalarda hipertansiyon, diabetes mellitus, dislipidemi ve
sigara kullanımı. Koroner bakım ünitesi (KBU) ve koğuşta çalışmaya
kabul edilen KAH olan 100 hasta katıldı. Demografik bilgileri not edildi. Boy,
kilo ve kan basıncı standart yöntemlerle kaydedildi. Kan şekeri ve lipit
profili, gece boyunca 12 saatlik aç kaldıktan sonra hesaplandı. Risk faktörleri
ölçümler, laboratuvar değerleri ve ayrıca aynı hastalık ve geçmiş ilaç öyküsü
ile kullanıldı. İstatistiksel analiz için SPSS-16 kullanıldı. Hastaların yaş
ortalaması 64,61 ± 11,363, en az 40, en fazla 94 idi. Genel olarak risk
faktörleri dağılımı çoktan aza doğru sırası ile sigara içme (% 55),
hipertansiyon (% 50), dislipidemi (% 49) ve diabetes mellitus (% 32) idi. Risk
faktörlerinin dağılımı 55-69 yaş grubunda en fazla idi. Bu çalışma koroner kalp
hastalığı olan hastaların çoğunun konvansiyonel risk faktörlerine sahip
olduğunu ve hastalığın gelişiminde büyük rol oynadığını göstermektedir.
Değiştirilebilir dört risk faktörünün yanı sıra, aynı zamanda yaş ve cinsiyetin
de değiştirilemeyen bu hastalığın önemli katkıları olabileceğini çalışmamız
göstermektedir.

Anahtar Kelimeler

Koroner arter hastalığı, diabetes mellitus, dislipidemi, etnisite, hipertansiyon, risk faktörleri, sigara içme

Study on The Conventional Risk Factors in Patients with Coronary Artery Disease in Tertiary Care Hospitals, Pokhara, Nepal

Öz

Coronary artery disease (CAD) has shown
a remarkable decline in the developed world in past few years, but has shown an
alarming increase in the developing world especially South Asia. The aim
of the study was to investigate four conventional risk factors: Hypertension,
diabetes mellitus, dyslipidemia and smoking in patients with coronary heart
disease in tertiary care hospitals of Pokhara valley, Nepal. 100 patients with
CAD who were admitted in the wards and coronary care unit (CCU) participated
in the study. Their demographic information was noted. Height, weight and blood
pressure were recorded with standard methods. Blood glucose and lipid profile
were estimated after 12 hours of fasting overnight. Risk factors were
determined using the measurements, laboratory values and also from the past
history of the same illness and medications if any. SPSS-16 was used for
statistical analysis. Mean age of the patients was 64.61±11.363 years with
minimum age 40 and maximum 94 years. Overall distribution of risk factors in
descending order was smoking (55%), hypertension (50%), dyslipidemia (49%) and
diabetes mellitus (32%). Distribution of risk factors was maximum in the age
group 55-69 years.  This study
shows that most of the patients with coronary heart disease have conventional
risk factors and they play a major role in the development of the disease.
Beside the four modifiable risk factors, our study also shows that age and
gender can be major contributors of the disease which can’t be modified.

Anahtar Kelimeler

Coronary artery disease, diabetes mellitus, dyslipidemia, ethnicity, hypertension, risk factors, smoking

Kaynakça

• Mohan V, Deepa R. Risk factors for coronary artery disease in Indians. JAPI. 2004 Feb;52:95-97.
• Kalra S, Narain S, Karki P, Ansari JA, Ranabhat K, Basnet N. Prevalence of risk factors for coronary artery disease in the community in eastern Nepal-a pilot study. JAssoc Physicians India. 2011;59:300-1.
• Shrestha UK, Bhattarai TN, Upadhyaya AB, Rajopadhyaya A, Rajopadhyaya S, Pandey MR. Heart Disease amongst the Civil Servants, Employees of Corporation and Academic Institutions in Nepal http://www.msmt.org.np/publication/download/civil. Accessed Jan 4, 2013.
• Coronary heart disease.[Updated 2014 June11].https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0063012/ Accessed Jan 2013.
• Edwards C.R.W, Bouchier I.A.D, Haslett C, Chilvers E.R.. Davidson’s Principles and Practice of Medicine.17th ed. London: Churchill Livingstone; 1996.p.245.
• Hatmi ZN, Mahdavi-Mazdeh M, Hashemi-Nazari SS, Hajiqhashemi E, Nozari B, Mahdavi A. Pattern of coronary artery disease risk factors in population younger than 55 yrs and above 55 yrs: a population study of 31,999 healthy individuals. Acta Med Iran. 2011;49(6):368-74.
• Nancy J, Bohannon V. Coronary artery disease and diabetes. Postgraduate medicine. 1999;105(2):66-80.
• Coronary Artery Disease. http://www.ma-yoclinic.org/diseaseconditions/coronarydisease/basics/symptoms/con0032038.Accessed 30 July 2014.
• Gander J, Sui X, Hazlett LJ, Hebert JR, Blair SN. Preventing chronic disease. http://wwwcdc.gov/pcd/issues/2014/14_0045.htm. Accessed Jan 11, 2015.
• Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, Ellis SG, Lincoff A M, Topol EJ. Prevalence Of Conventional Risk Factors in Patients With Coronary Heart disease. JAMA. 2003 Aug;290:898-904.
• Parajuli M, Maskey A, Kohli S C, Shrestha UK. Gender Difference in Frequency of Conventional Risk Factors in Patients with Acute Coronary Syndrome Admitted in Manipal Teaching Hospital, Pokhara, Nepal. NJMS. 2012;1(1): 31-34.
• Poudel B, Poudel R, Maskey A, Shrestha G, Poudel K, Panta B. A study of acute coronary syndrome in western region of Nepal. Journal of Gandaki Medical college. 2009;2:51-9.
• Achari V, Thakur AK. Association of major modifiable risk factors among patients with coronary artery disease--a retrospective analysis. J Assoc Physicians India. 2004 Feb;52:103-8.
• Pepine CJ. Systemic hypertension and coronary artery disease. Am J Cardiol. 1998 Aug;82(3):21-24.
• Murthy PD, Prasad KT, Gopal PV, Rao KV, Rao RM. A survey for prevalence of coronary artery disease and its risk factors in an urban population in Andhra Pradesh. J Assoc Physicians India 2012 Mar;60:17-20.
• Nesto RW. Prevalence of and risk factors for coronary heart disease in diabetes mellitus.Http://www.uptodate.com/contets/prevalence-of-and-risk-factors-for corona ry-heart-disease-in-diabetes-mellitus. Acc-essed 13 Aug 2014.
• Lanza GA. Ethnic variations in acute coronary syndromes. Heart. 2004 Jun; 90(6):595–597. Doi: 10.1136/hrt.2003. 026476.