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Improving Health Outcomes through the Secondary Prevention of Cardiovascular Disease

Improving Health Outcomes through the Secondary Prevention of Cardiovascular Disease. The Importance of Access to Medicines. Chris Ward June 2013. The Burden of NCDs in Russia. Socioeconomic Impacts of Cardiovascular Diseases in Russia.

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Improving Health Outcomes through the Secondary Prevention of Cardiovascular Disease

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  1. Improving Health Outcomes through the Secondary Prevention of Cardiovascular Disease The Importance of Access to Medicines Chris Ward June 2013

  2. The Burden of NCDs in Russia

  3. Socioeconomic Impacts of Cardiovascular Diseases in Russia Cardiovascular diseases (CVD) are a major public health and socioeconomic problem in Russia The standardized mortality rate from CVD in Russia is two to three times higher than in developed countries. A distinctive feature of CVD mortality in Russia is that most deaths due to these causes occur in working age groups This indirect damage is very important for Russia’s economy, as permanent loss of the labor potential of the country is always a threat to the social and economic welfare of a society Source: Petrukhin IS, Lunina EY. Cardiovascular disease risk factors and mortality in Russia: challenges and barriers. Public Health Reviews. 2012;33:436-49

  4. Impact of Indirect Costs of CVD in Russia • In 2009 the economic burden of CVD in Russia is estimated to be €24.4 billion • 80% of the economic costs are indirect - related to lost productivity • CVD economic losses are 3% of GDP Economic Burden of Cardiovascular Diseases in the Russian Federation Anna Kalinina & Anna Kontsevaya, Nartional Research Centre for Preventive Medicine, Moscow

  5. The Challenge of Changing Lifestyle Behaviors Despite the proven benefits of exercise, few people in Russia engage in regular physical activity. In the European Union, only 31 percent of respondents had a sufficient level of physical activity Strategies for primary prevention of hypertension (lowering alcohol consumption, healthy diet, weight control and physical activity) are important but this needs to be combined with effective antihypertensive therapy. Petrukhin IS, Lunina EY. Cardiovascular disease risk factors and mortality in Russia: challenges and barriers. Public Health Reviews. 2012;33:436-49

  6. Urgent Need to Address Management of Hypertension The contribution of hypertension to total mortality rates is about 35 percent. Russian men and women with elevated systolic BP (> 180 mm Hg) live 12.2 years and 6.0 years less than those with normal BP. The management of hypertension and development of health promotion measures are critical to the further reduction of the mass premature deaths due to CVD of Russian men and to a lesser extent women. Petrukhin IS, Lunina EY. Cardiovascular disease risk factors and mortality in Russia: challenges and barriers. Public Health Reviews. 2012;33:436-49

  7. P.U.R.E. Study on Use of Medicines for Secondary Prevention of CVD Prospective Urban Rural Epidemiological study looked at the use of proven, effective low-cost therapies for the secondary prevention of CDV throughout the world. The study included 154,000 adults between the ages of 35 and 70 with a history of heart disease or stroke living in 17 high, middle and low-income countries. Data included use of medication, age, gender, education and key risk factors such as smoking, diabetes, hypertension and obesity. The study demonstrated that both in high and low-income countries there was a surprising underuse of inexpensive and commonly available therapies such as aspirin. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey Salim Yusuf et al www.thelancet.com Published online August 28, 2011 DOI:10.1016/S0140-6736(11)61215-4

  8. The Underuse of Proven Low-Cost Medicines for Secondary Prevention Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey Salim Yusuf et al www.thelancet.com Published online August 28, 2011 DOI:10.1016/S0140-6736(11)61215-4

  9. P.U.R.E. Study Conclusions: A Wasted Opportunity “Improvements to the uptake of effective secondary prevention strategies are probably more feasible than are lifestyle modifications in primary prevention (although both are desirable).” These medicines are of proven benefit, are low cost and could significantly improve the life expectancy of the Russian population that suffers from an inordinately high mortality rate from cardiovascular diseases. According to lead author Salim Yusuf "the data are extremely disturbing and indicate a need for systematic efforts to understand why even inexpensive medications are substantially under-utilized worldwide” …. “This is a global tragedy and represents a huge wasted opportunity to help millions of people with heart disease. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey , Salim Yusuf et al www.thelancet.com Published online August 28, 2011 DOI:10.1016/S0140-6736(11)61215-4

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