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Temporal trends in ...
Temporal trends in cardiovascular risk factors, lifestyle and secondary preventive medication for patients with myocardial infarction attending cardiac rehabilitation in Sweden 2006-2019 : a registry-based cohort study
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- Leosdottir, Margret (författare)
- Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital,Skane Univ Hosp, Sweden; Lund Univ, Sweden
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- Hagström, Emil (författare)
- Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala Univ, Sweden; Uppsala Clin Res Ctr, Sweden
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- Hadziosmanovic, Nermin (författare)
- Uppsala University,Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Uppsala Clin Res Ctr, Sweden
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- Norhammar, Anna (författare)
- Karolinska Institute,Karolinska Inst, Sweden; Capio Sankt Gorans Sjukhus, Sweden
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- Lindahl, Bertil, 1957- (författare)
- Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala Univ, Sweden; Uppsala Clin Res Ctr, Sweden
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- Hambraeus, Kristina (författare)
- Falun Cent Hosp, Dept Cardiol, Falun, Dalarna, Sweden.,Falun Central Hospital
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- Jernberg, Tomas (författare)
- Karolinska Institutet,Danderyd Hosp, Sweden
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- Bäck, Maria (författare)
- Linköpings universitet,Linköping University,Sahlgrenska University Hospital,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Sahlgrens Univ Hosp, Sweden
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(creator_code:org_t)
- BMJ Publishing Group Ltd, 2023
- 2023
- Engelska.
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:5
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Abstract
Ämnesord
Stäng
- Objectives: Registries have been highlighted as means to improve quality of care. Here, we describe temporal trends in risk factors, lifestyle and preventive medication for patients after myocardial infarction (MI) registered in the quality registry Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART).Design: A registry-based cohort study.Setting: All coronary care units and cardiac rehabilitation (CR) centres in Sweden.Participants: Patients attending a CR visit at 1-year post-MI 2006-2019 were included (n=81 363, 18-74 years, 74.7% men).Outcome measures: Outcome measures at 1-year follow-up included blood pressure (BP) <140/90 mm Hg, low-density lipoprotein-cholesterol (LDL-C)<1.8 mmol/L, persistent smoking, overweight/obesity, central obesity, diabetes prevalence, inadequate physical activity, and prescription of secondary preventive medication. Descriptive statistics and testing for trends were applied.Results: The proportion of patients attaining the targets for BP<140/90 mmHg increased from 65.2% (2006) to 86.0% (2019), and LDL-C<1.8 mmol/L from 29.8% (2006) to 66.9% (2019, p<0.0001 both). While smoking at the time of MI decreased (32.0% to 26.5%, p<0.0001), persistent smoking at 1 year was unchanged (42.8% to 43.2%, p=0.672) as was the prevalence of overweight/obesity (71.9% to 72.9%, p=0.559). Central obesity (50.5% to 57.0%), diabetes (18.2% to 27.2%) and patients reporting inadequate levels of physical activity (57.0% to 61.5%) increased (p<0.0001 for all). From 2007, >90.0% of patients were prescribed statins and approximately 98% antiplatelet and/or anticoagulant therapy. Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescription increased from 68.7% (2006) to 80.2% (2019, p<0.0001).Conclusions: While little change was observed for persistent smoking and overweight/obesity, large improvements were observed for LDL-C and BP target achievements and prescription of preventive medication for Swedish patients after MI 2006-2019. Compared with published results from patients with coronary artery disease in Europe during the same period, these improvements were considerably larger. Continuous auditing and open comparisons of CR outcomes might possibly explain some of the observed improvements and differences.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Nyckelord
- Myocardial infarction
- REHABILITATION MEDICINE
- Quality in health care
- Coronary heart disease
- Risk management
- Coronary heart disease
- Myocardial infarction
- Quality in health care
- REHABILITATION MEDICINE
- Risk management
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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