Question

Compare and contrast the global burden of coronary heart disease with the global burden of stroke

Include the following points in your discussion:

• Similarities in deaths from coronary heart disease and deaths from stroke.
• Differences in deaths from coronary heart disease and deaths from stroke.
• Reflect on your findings

Make sure your 300-word response is properly referenced from a “reputable” and “published” report / paper/ policy.

Answer 1

Ans) Stroke is a risk factor for coronary heart disease. People with coronary heart disease, angina or who have had a heart attack due to atherosclerosis (hardening of the arteries) have more than twice the risk of stroke.

- Coronary heart disease (CHD) and stroke have common risk factors, but some of these differ in the magnitude or direction of associations between CHD and stroke.

- In total, 104 910 subjects aged 40-79 years without histories of cancer, CHD and stroke at baseline were followed between 1988 and 2009.

- Competing-risks analysis was used to test for differences in the associations of each risk factor with two endpoints (CHD and stroke). Population attributable fractions (PAFs) were also calculated for these endpoints to estimate the population impact of each risk factor.

-During a median 19.1-year follow-up, 1554 died from CHD and 3163 from stroke. The association of hypertension with CHD was similar to that with stroke in terms of the magnitude and direction (multivariable-adjusted hazard ratio for CHD: 1.63 vs. stroke: 1.73 in men and 1.70 vs. 1.66 in women).

- Conversely, the magnitude of these associations differed for smoking (CHD: 1.95 vs. stroke: 1.23 in men and 2.45 vs. 1.35 in women) and diabetes (1.49 vs. 1.09 in men and 2.08 vs. 1.39 in women).

- The highest PAF for CHD was caused by smoking in men and by hypertension in women; that for stroke was caused by hypertension in both sexes.

- Hypertension associations and PAFs were consistent between CHD and stroke, but not for other risk factors. These findings may be useful to optimize public health intervention strategies.