Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/101582 |
Resumo: | Introduction and Objective: Every year cardiovascular disease (CVD) causes 3.9 million deaths in Europe. Portugal has implemented a set of public health policies to tackle CVD mortality: a smoking ban in 2008, a salt reduction regulation in 2010 and the coronary fast-track system (FTS) for acute coronary syndrome (ACS) in 2007. Our goal in this study was to analyze the impact of these three public health policies in reducing case-fatality rates from ACS between 2000 and 2016. Methods: The impact of these policies on monthly ACS case-fatalities was assessed by creating individual models for each of the initiatives and implementing multiple linear regression analysis, using standard methods for interrupted time series. We also implemented segmented regression analysis to test which year showed a significant difference in the case-fatality slopes. Results: Separate modeling showed that the smoking ban (beta=-0.861, p=0.050) and the FTS (beta=-1.27, p=0.003) had an immediate impact after implementation, but did not have a significant impact on ACS trends. The salt reduction regulation did not have a significant impact. For the segmented model, we found significant differences between case-fatality trends before and after 2009, with rates before 2009 showing a steeper decrease. Conclusions: The smoking ban and the FTS led to an immediate decrease in case-fatality rates; however, after 2009 no major decrease in case-fatality trends was found. Coronary heart disease constitutes an immense public health problem and it remains essential for decision-makers, public health authorities and the cardiology community to keep working to reduce ACS mortality rates. |
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Impact of public health initiatives on acute coronary syndrome fatality rates in PortugalImpacto das medidas de saúde pública na mortalidade intra-hospitalar por síndrome coronária aguda em PortugalAcute coronary syndromeCardiovascular healthCase-fatality ratePublic healthCardiology and Cardiovascular MedicineSDG 3 - Good Health and Well-beingIntroduction and Objective: Every year cardiovascular disease (CVD) causes 3.9 million deaths in Europe. Portugal has implemented a set of public health policies to tackle CVD mortality: a smoking ban in 2008, a salt reduction regulation in 2010 and the coronary fast-track system (FTS) for acute coronary syndrome (ACS) in 2007. Our goal in this study was to analyze the impact of these three public health policies in reducing case-fatality rates from ACS between 2000 and 2016. Methods: The impact of these policies on monthly ACS case-fatalities was assessed by creating individual models for each of the initiatives and implementing multiple linear regression analysis, using standard methods for interrupted time series. We also implemented segmented regression analysis to test which year showed a significant difference in the case-fatality slopes. Results: Separate modeling showed that the smoking ban (beta=-0.861, p=0.050) and the FTS (beta=-1.27, p=0.003) had an immediate impact after implementation, but did not have a significant impact on ACS trends. The salt reduction regulation did not have a significant impact. For the segmented model, we found significant differences between case-fatality trends before and after 2009, with rates before 2009 showing a steeper decrease. Conclusions: The smoking ban and the FTS led to an immediate decrease in case-fatality rates; however, after 2009 no major decrease in case-fatality trends was found. Coronary heart disease constitutes an immense public health problem and it remains essential for decision-makers, public health authorities and the cardiology community to keep working to reduce ACS mortality rates.Escola Nacional de Saúde Pública (ENSP)Centro de Investigação em Saúde Pública (CISP/PHRC)RUNAbreu, DaisySousa, PauloMatias-Dias, CarlosPinto, Fausto2020-07-27T22:45:29Z2020-012020-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article8application/pdfhttp://hdl.handle.net/10362/1015820870-2551PURE: 19221813https://doi.org/10.1016/j.repc.2019.05.010info:eu-repo/semantics/openAccessporreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:47:49Zoai:run.unl.pt:10362/101582Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:39:35.854567Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal Impacto das medidas de saúde pública na mortalidade intra-hospitalar por síndrome coronária aguda em Portugal |
title |
Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal |
spellingShingle |
Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal Abreu, Daisy Acute coronary syndrome Cardiovascular health Case-fatality rate Public health Cardiology and Cardiovascular Medicine SDG 3 - Good Health and Well-being |
title_short |
Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal |
title_full |
Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal |
title_fullStr |
Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal |
title_full_unstemmed |
Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal |
title_sort |
Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal |
author |
Abreu, Daisy |
author_facet |
Abreu, Daisy Sousa, Paulo Matias-Dias, Carlos Pinto, Fausto |
author_role |
author |
author2 |
Sousa, Paulo Matias-Dias, Carlos Pinto, Fausto |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Escola Nacional de Saúde Pública (ENSP) Centro de Investigação em Saúde Pública (CISP/PHRC) RUN |
dc.contributor.author.fl_str_mv |
Abreu, Daisy Sousa, Paulo Matias-Dias, Carlos Pinto, Fausto |
dc.subject.por.fl_str_mv |
Acute coronary syndrome Cardiovascular health Case-fatality rate Public health Cardiology and Cardiovascular Medicine SDG 3 - Good Health and Well-being |
topic |
Acute coronary syndrome Cardiovascular health Case-fatality rate Public health Cardiology and Cardiovascular Medicine SDG 3 - Good Health and Well-being |
description |
Introduction and Objective: Every year cardiovascular disease (CVD) causes 3.9 million deaths in Europe. Portugal has implemented a set of public health policies to tackle CVD mortality: a smoking ban in 2008, a salt reduction regulation in 2010 and the coronary fast-track system (FTS) for acute coronary syndrome (ACS) in 2007. Our goal in this study was to analyze the impact of these three public health policies in reducing case-fatality rates from ACS between 2000 and 2016. Methods: The impact of these policies on monthly ACS case-fatalities was assessed by creating individual models for each of the initiatives and implementing multiple linear regression analysis, using standard methods for interrupted time series. We also implemented segmented regression analysis to test which year showed a significant difference in the case-fatality slopes. Results: Separate modeling showed that the smoking ban (beta=-0.861, p=0.050) and the FTS (beta=-1.27, p=0.003) had an immediate impact after implementation, but did not have a significant impact on ACS trends. The salt reduction regulation did not have a significant impact. For the segmented model, we found significant differences between case-fatality trends before and after 2009, with rates before 2009 showing a steeper decrease. Conclusions: The smoking ban and the FTS led to an immediate decrease in case-fatality rates; however, after 2009 no major decrease in case-fatality trends was found. Coronary heart disease constitutes an immense public health problem and it remains essential for decision-makers, public health authorities and the cardiology community to keep working to reduce ACS mortality rates. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-07-27T22:45:29Z 2020-01 2020-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/101582 |
url |
http://hdl.handle.net/10362/101582 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
0870-2551 PURE: 19221813 https://doi.org/10.1016/j.repc.2019.05.010 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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8 application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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