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PT022 Sofia Declaration for Prevention of Cardiovascular Diseases and Type 2 Diabetes Mellitus: A Scientific Statement
POSTER ABSTRACTS
cities. Additionally, we present an exploratory modelling framework for evaluating environmental predictors of CVD risk. Methods: The study population comprises participants in the Canadian cohort of the Prospective Urban and Rural Epidemiology (PURE) study. Each participant’s WHR was calculated and then mapped by their home postal code. The precise locations of fast food restaurants in each study area were recorded and mapped. A neighbourhood score of local fast food restaurant density was then calculated for each study participant and used as the independent variable for modelling. Aspatial and geographically-weighted sex-specific linear models were constructed to predict WHR based on participants’ local fast food density. Models were adjusted by age, SES, and population density. Geographically-weighted linear models allow coefficients to vary spatially, and these coefficients are mapped to identify communities with differing fast food/obesity relationships. Results: Adjusted sex-specific aspatial linear models captured between 2% and 12% of the variation in WHR, while the geographically-weighted models performed better at 5% to 17%. The correlation of fast food score with WHR varied within and between cities, such that it was a positive predictor in some neighbourhoods and a negative predictor in others. These differences may highlight underlying local contextual factors that modify the role of fast food environments in obesity; detailed local investigations of these communities will inform a more comprehensive understanding of these patterns. Conclusion: A geographical modelling approach holds significant value for evaluating community-level environmental determinants of CVD risk, specifically for informing policy programmes at the local scale. Disclosure of Interest: None Declared PT019 The Association Between Malnutrition in Early Life, Season of Birth and Health Related Quality of Life Among Chinese Adults in Chongqing, China X. Xu*1,2,3, Y. Rao4, L. Liu1, Y. Zhao1,2,3 1 School of Public Health and Management, 2Research Center for Medicine and Social Development, 3The Innovation Center for Social Risk Governance in Health, 4School of Nursing, Chongqing Medical University, Chongqing, China Introduction: Previous research suggested that increased risk of chronic diseases in adulthood might actually originate from adverse exposures or undernutrition during early life. SF36 Quality of Life Measures has been shown to be both valid and acceptable in a normal healthy population and reliable across diverse patient groups. Objectives: This study aimed at the association between malnutrition in early life, season of birth and health related quality of life. Methods: From July to September 2009, we adopted multi-stage stratified random sampling cross-sectional survey to collect 1,224 eligible adults born between 1956 and 1964 in Chongqing. The participants were categorized into three groups based on birth date: 1) childhood exposure: 299 (born between 11/1, 1956w9/30, 1958), 2) fetal exposure: 455 (born between 10/1, 1959w9/30, 1961), 3) non-exposure: 470 (born between 10/1, 1962w9/30, 1964). ANOVA was used to compare differences in continuous variables in three groups and four groups. Results: We found that individuals exposed to famine when childhood and fetal were statistically significantly lower in the scores of “physical functioning” (p¼0.0094) and “role-physical” (p¼0.0165) than non-exposed to famine. However, childhood and fetal exposure were statistically significantly higher scores “vitality” (p¼0.0003) than non-exposed to famine. Individuals exposed to famine when childhood were statistically significantly higher in the score of “role-emotional” (p<0.0001) non-exposed to famine, whereas individuals exposed to famine when fetal were significantly lower in the score of “role-emotional” (p<0.0001) than non-exposed to famine. No statistically significant differences were observed on in the score of “Physical functioning (p¼0.5208)”, “Mental health (p¼0.4673)”, “Social functioning (p¼0.6228)”, “and Vitality (p¼0.2770)”, “Bodily pain (p¼0.8501)”, “General health (p¼0.7376)”, “Rolephysical (p¼0.2816)”, and “Role-emotional (p¼0.0784)” among the four season of birth groups. Conclusion: This study suggests that malnutrition in early life may affect health related quality of life in adulthood. This study indicates that the season of birth may not affect health related quality of life in adulthood. Disclosure of Interest: None Declared PT020 Factors Influencing Sleeping and the Impact of Sleeping on Quality of Life Among Chinese Middle-Aged Adults in Chongqing, China X. Xu*1,2,3, Y. Rao4, D. Liu1, Y. Zhao1,2,3 1 School of Public Health and Management, 2Research Center for Medicine and Social Development, 3The Innovation Center for Social Risk Governance in Health, 4School of Nursing, Chongqing Medical University, Chongqing, China Introduction: Poor sleep is a risk factor of chronic diseases, and affects quality of life. Poor sleep has become a serious public health problem globally. However, few study on the impact of sleeping on quality of life in Chinese populations. Objectives: This study aimed to explore factors influencing sleeping and the impact of sleeping on quality of life among Chinese middle-aged adults.
e130
Methods: From July to September 2009, we adopted multi-stage stratified random sampling survey to recruit 1,224 eligible adults (born November 1, 1956–September 30, 1964) in Chongqing. Sleep quality was self-reported measured. SF36 Quality of Life measures were used to measure quality of life. Results: 734 (59.97%) participants have poor self-reported sleep. Statistically significant differences were observed in the mean score of SF36 Quality of Life Measures that “Physical functioning”, “Mental health” and “Role-emotional (p<0.0001)” between participants who have good sleep and those have poor sleep. We found that individuals who sometimes have a regular daily life was more likely to have poor sleep (OR¼1.623, 95% CI [1.215, 2.168]) than whom seldom have a regular daily life. Individuals who usually have a regular daily life were more likely to have poor sleep (OR¼2.014, 95% CI [1.091, 3.717]) than whom seldom have a regular daily life. Persons who have poor self-reported appetite was more likely to have poor sleep (OR¼8.425, 95% CI [6.329, 11.215]) than whom have good appetite. Conclusion: More than half of participants have poor self-reported sleep. It’s necessary to pay more attention to the sleep quality of middle-aged adults. Sleep can affect “Physical functioning”, “Mental health” and “Role-emotional among middle-aged adults. Measures to improve the sleep quality of middle-aged adults should pay attention to regular daily life and appetite. Disclosure of Interest: None Declared PT022 Sofia Declaration for Prevention of Cardiovascular Diseases and Type 2 Diabetes Mellitus: A Scientific Statement K. Hristova*1 1 Noninvasive Functional Diagnostic and Imaging, National Heart Hospital, Sofia, Sofia, Bulgaria Introduction: There has been persistent emphasis from various health agencies on the prevention of cardiovascular diseases (CVDs) and other chronic diseases. Objectives: This review focusses on the emergence of CVDs and other chronic diseases as well as on modern strategies for their prevention. Methods: A systematic and narrative review was conducted using such reference databases as MEDLINE (PubMed), Web of Science and EBSCO, with additional secondary sources and grey literature searching. Opinions of experts were also sought and discussions followed. Results: The prevalence of primary risk factors for most chronic diseases is rapidly increasing in low and middle income populations due to the on-going economic development and progress. There is a decrease in such risk factors in the developed countries as due to education and adoption of preventive strategies result in a reduction in CVD mortality. Hypertension (5-10%), type 2 diabetes (3-5%) and CAD (3-4%) are very low in the adult rural populations of India, China, and in the African sub-continent which has less economic development. It seems that it is not poverty, but the lack of health education, possibly due to ineffective policies of national and local governments. In urban and immigrant populations of India and China, which are economically better off, NCDs are significantly higher than they are in some of the high-income populations. Health education and promotion of healthier lifestyle and behaviour appear to be important for prevention in such countries. Conclusion: These findings may require modification of the existing American and European guidelines, proposed for the prevention of CVDs and other chronic diseases, in high-income populations. Disclosure of Interest: None Declared PT023 The Economic Burden of Heart Diseases in Peru L. Pezzullo*1, B. Stevens1, L. Verdian1, J. Tomlinson1, S. Zegenhagen1 1 Health Economics, Deloitte Access Economics, Melbourne, Australia Introduction: Heart disease (HD) is currently the leading cause of death in the Latin American region and expected to remain so for future decades. HD imposes health care system and other costs to society through morbidity, premature mortality, carer costs and loss of productivity. The economic burden of heart disease in the Latin American region has not been previously quantified. Objectives: The study aim was to assess the economic burden of heart failure (HF), myocardial infarction (MI), atrial fibrillation (AF), and hypertension (HY) in Peru, and the cost effectiveness (CE) of two interventions for HF. Methods: The cost of HD in Peru was estimated using a prevalence approach for HF, AF and HY, and an incidence approach for MI. This was done by estimating the number of people with HD in a base period (2015) and the costs associated with the condition in that period. The cost estimates included health system expenditures as well as other financial costs including productivity losses from absenteeism and informal care costs. We also estimated transfer costs in order to better understand how costs were borne by government, individuals and society. Estimates were also made of the value of the loss of healthy life, measured in disability adjusted life years (DALYs) using global burden of disease disability weights. To estimate the number of cases of HD in the population, by age and gender, epidemiological data on prevalence rates were applied to population data. Data inputs were informed by a targeted literature review that provided Peru specific disease estimates and a data scan and amalgamation of Organisation for Economic Co-operation and Development, World Health Organisation and regional estimates. Estimates were triangulated using semistructured interviews with clinicians, insurers and health administrators. Results: Accounting for co-morbidities, these HDs were found to affect approximately 3 million people in 2015 in Peru (9.6% of the population). This leads to significant wellbeing loss, estimated at 354,995 DALYs, and economic burden, estimated at totalling 9 billion sol in 2015. Condition specific results are in Table i. CE results will be forthcoming.
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS
cities. Additionally, we present an exploratory modelling framework for evaluating environmental predictors of CVD risk. Methods: The study population comprises participants in the Canadian cohort of the Prospective Urban and Rural Epidemiology (PURE) study. Each participant’s WHR was calculated and then mapped by their home postal code. The precise locations of fast food restaurants in each study area were recorded and mapped. A neighbourhood score of local fast food restaurant density was then calculated for each study participant and used as the independent variable for modelling. Aspatial and geographically-weighted sex-specific linear models were constructed to predict WHR based on participants’ local fast food density. Models were adjusted by age, SES, and population density. Geographically-weighted linear models allow coefficients to vary spatially, and these coefficients are mapped to identify communities with differing fast food/obesity relationships. Results: Adjusted sex-specific aspatial linear models captured between 2% and 12% of the variation in WHR, while the geographically-weighted models performed better at 5% to 17%. The correlation of fast food score with WHR varied within and between cities, such that it was a positive predictor in some neighbourhoods and a negative predictor in others. These differences may highlight underlying local contextual factors that modify the role of fast food environments in obesity; detailed local investigations of these communities will inform a more comprehensive understanding of these patterns. Conclusion: A geographical modelling approach holds significant value for evaluating community-level environmental determinants of CVD risk, specifically for informing policy programmes at the local scale. Disclosure of Interest: None Declared PT019 The Association Between Malnutrition in Early Life, Season of Birth and Health Related Quality of Life Among Chinese Adults in Chongqing, China X. Xu*1,2,3, Y. Rao4, L. Liu1, Y. Zhao1,2,3 1 School of Public Health and Management, 2Research Center for Medicine and Social Development, 3The Innovation Center for Social Risk Governance in Health, 4School of Nursing, Chongqing Medical University, Chongqing, China Introduction: Previous research suggested that increased risk of chronic diseases in adulthood might actually originate from adverse exposures or undernutrition during early life. SF36 Quality of Life Measures has been shown to be both valid and acceptable in a normal healthy population and reliable across diverse patient groups. Objectives: This study aimed at the association between malnutrition in early life, season of birth and health related quality of life. Methods: From July to September 2009, we adopted multi-stage stratified random sampling cross-sectional survey to collect 1,224 eligible adults born between 1956 and 1964 in Chongqing. The participants were categorized into three groups based on birth date: 1) childhood exposure: 299 (born between 11/1, 1956w9/30, 1958), 2) fetal exposure: 455 (born between 10/1, 1959w9/30, 1961), 3) non-exposure: 470 (born between 10/1, 1962w9/30, 1964). ANOVA was used to compare differences in continuous variables in three groups and four groups. Results: We found that individuals exposed to famine when childhood and fetal were statistically significantly lower in the scores of “physical functioning” (p¼0.0094) and “role-physical” (p¼0.0165) than non-exposed to famine. However, childhood and fetal exposure were statistically significantly higher scores “vitality” (p¼0.0003) than non-exposed to famine. Individuals exposed to famine when childhood were statistically significantly higher in the score of “role-emotional” (p<0.0001) non-exposed to famine, whereas individuals exposed to famine when fetal were significantly lower in the score of “role-emotional” (p<0.0001) than non-exposed to famine. No statistically significant differences were observed on in the score of “Physical functioning (p¼0.5208)”, “Mental health (p¼0.4673)”, “Social functioning (p¼0.6228)”, “and Vitality (p¼0.2770)”, “Bodily pain (p¼0.8501)”, “General health (p¼0.7376)”, “Rolephysical (p¼0.2816)”, and “Role-emotional (p¼0.0784)” among the four season of birth groups. Conclusion: This study suggests that malnutrition in early life may affect health related quality of life in adulthood. This study indicates that the season of birth may not affect health related quality of life in adulthood. Disclosure of Interest: None Declared PT020 Factors Influencing Sleeping and the Impact of Sleeping on Quality of Life Among Chinese Middle-Aged Adults in Chongqing, China X. Xu*1,2,3, Y. Rao4, D. Liu1, Y. Zhao1,2,3 1 School of Public Health and Management, 2Research Center for Medicine and Social Development, 3The Innovation Center for Social Risk Governance in Health, 4School of Nursing, Chongqing Medical University, Chongqing, China Introduction: Poor sleep is a risk factor of chronic diseases, and affects quality of life. Poor sleep has become a serious public health problem globally. However, few study on the impact of sleeping on quality of life in Chinese populations. Objectives: This study aimed to explore factors influencing sleeping and the impact of sleeping on quality of life among Chinese middle-aged adults.
e130
Methods: From July to September 2009, we adopted multi-stage stratified random sampling survey to recruit 1,224 eligible adults (born November 1, 1956–September 30, 1964) in Chongqing. Sleep quality was self-reported measured. SF36 Quality of Life measures were used to measure quality of life. Results: 734 (59.97%) participants have poor self-reported sleep. Statistically significant differences were observed in the mean score of SF36 Quality of Life Measures that “Physical functioning”, “Mental health” and “Role-emotional (p<0.0001)” between participants who have good sleep and those have poor sleep. We found that individuals who sometimes have a regular daily life was more likely to have poor sleep (OR¼1.623, 95% CI [1.215, 2.168]) than whom seldom have a regular daily life. Individuals who usually have a regular daily life were more likely to have poor sleep (OR¼2.014, 95% CI [1.091, 3.717]) than whom seldom have a regular daily life. Persons who have poor self-reported appetite was more likely to have poor sleep (OR¼8.425, 95% CI [6.329, 11.215]) than whom have good appetite. Conclusion: More than half of participants have poor self-reported sleep. It’s necessary to pay more attention to the sleep quality of middle-aged adults. Sleep can affect “Physical functioning”, “Mental health” and “Role-emotional among middle-aged adults. Measures to improve the sleep quality of middle-aged adults should pay attention to regular daily life and appetite. Disclosure of Interest: None Declared PT022 Sofia Declaration for Prevention of Cardiovascular Diseases and Type 2 Diabetes Mellitus: A Scientific Statement K. Hristova*1 1 Noninvasive Functional Diagnostic and Imaging, National Heart Hospital, Sofia, Sofia, Bulgaria Introduction: There has been persistent emphasis from various health agencies on the prevention of cardiovascular diseases (CVDs) and other chronic diseases. Objectives: This review focusses on the emergence of CVDs and other chronic diseases as well as on modern strategies for their prevention. Methods: A systematic and narrative review was conducted using such reference databases as MEDLINE (PubMed), Web of Science and EBSCO, with additional secondary sources and grey literature searching. Opinions of experts were also sought and discussions followed. Results: The prevalence of primary risk factors for most chronic diseases is rapidly increasing in low and middle income populations due to the on-going economic development and progress. There is a decrease in such risk factors in the developed countries as due to education and adoption of preventive strategies result in a reduction in CVD mortality. Hypertension (5-10%), type 2 diabetes (3-5%) and CAD (3-4%) are very low in the adult rural populations of India, China, and in the African sub-continent which has less economic development. It seems that it is not poverty, but the lack of health education, possibly due to ineffective policies of national and local governments. In urban and immigrant populations of India and China, which are economically better off, NCDs are significantly higher than they are in some of the high-income populations. Health education and promotion of healthier lifestyle and behaviour appear to be important for prevention in such countries. Conclusion: These findings may require modification of the existing American and European guidelines, proposed for the prevention of CVDs and other chronic diseases, in high-income populations. Disclosure of Interest: None Declared PT023 The Economic Burden of Heart Diseases in Peru L. Pezzullo*1, B. Stevens1, L. Verdian1, J. Tomlinson1, S. Zegenhagen1 1 Health Economics, Deloitte Access Economics, Melbourne, Australia Introduction: Heart disease (HD) is currently the leading cause of death in the Latin American region and expected to remain so for future decades. HD imposes health care system and other costs to society through morbidity, premature mortality, carer costs and loss of productivity. The economic burden of heart disease in the Latin American region has not been previously quantified. Objectives: The study aim was to assess the economic burden of heart failure (HF), myocardial infarction (MI), atrial fibrillation (AF), and hypertension (HY) in Peru, and the cost effectiveness (CE) of two interventions for HF. Methods: The cost of HD in Peru was estimated using a prevalence approach for HF, AF and HY, and an incidence approach for MI. This was done by estimating the number of people with HD in a base period (2015) and the costs associated with the condition in that period. The cost estimates included health system expenditures as well as other financial costs including productivity losses from absenteeism and informal care costs. We also estimated transfer costs in order to better understand how costs were borne by government, individuals and society. Estimates were also made of the value of the loss of healthy life, measured in disability adjusted life years (DALYs) using global burden of disease disability weights. To estimate the number of cases of HD in the population, by age and gender, epidemiological data on prevalence rates were applied to population data. Data inputs were informed by a targeted literature review that provided Peru specific disease estimates and a data scan and amalgamation of Organisation for Economic Co-operation and Development, World Health Organisation and regional estimates. Estimates were triangulated using semistructured interviews with clinicians, insurers and health administrators. Results: Accounting for co-morbidities, these HDs were found to affect approximately 3 million people in 2015 in Peru (9.6% of the population). This leads to significant wellbeing loss, estimated at 354,995 DALYs, and economic burden, estimated at totalling 9 billion sol in 2015. Condition specific results are in Table i. CE results will be forthcoming.
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS