UN report: high cholesterol no longer an affliction of developed countries

No longer a “rich-country” affliction, high cholesterol is now hitting people in middle-income countries in big numbers — but a majority worldwide remains untreated, according to the largest study of the issue ever conducted.  (source: Vancouver Sun)

This study, published in the Bulletin – the international public health journal of the World Health Organization – is the first to show the extent of the treatment gap for high cholesterol – a common risk factor for early cardiovascular deaths. In Thailand, for example, 78% of adults surveyed had not been diagnosed, while in Japan, 53% of adults were diagnosed but remained untreated.

Cardiovascular diseases are the world’s biggest killers, claiming more than 17 million lives each year worldwide.

“Cholesterol-lowering medication is widely available, highly effective and can play an essential role in reducing cardiovascular disease around the world,” said study co-author, Dr Gregory A Roth, from the Institute for Health Metrics and Evaluation in the United States of America. “Despite these facts, effective medication coverage for control of high cholesterol remains disappointingly low.”

Combating chronic disease – discussion at the WEF 2011

An interesting discussion on the global impact of chronic disease at the World Economic Forum 2011 in Davos.

This plenary (moderated by Sanjay Gupta, Chief Medical Correspondent, CNN International) is an hour long, but features some very interesting speakers including:

• Ban Ki-moon, Secretary-General, United Nations, New York
• Richard T. Clark, Chairman, Merck, USA
• Julio Frenk, Dean, Harvard School of Public Health, USA
• Paul E. Jacobs, Chairman and Chief Executive Officer, Qualcomm, USA; Telecom Industry Agenda Council
• Kendall J. Powell, Chairman and Chief Executive Officer, General Mills, USA

Children breathe easier with smoke-free laws

(Reuters Health) – Children with asthma who live in areas with “smoke-free” laws may suffer fewer bouts of coughing and wheezing as a result, a new study suggests.

The findings, reported in the journal Pediatrics, add to evidence that smoking bans in workplaces, restaurants and bars have produced health benefits. But until now, most research has focused on adults.

In the current study, researchers found that children and teenagers who lived in U.S. counties with smoke-free laws were no less likely to have asthma than kids in counties without such laws.

Kids with asthma were, however, less likely to report persistent problems with wheezing and nighttime coughing bouts when they lived in smoke-free counties.

Lower education level tied to heart failure risk

A recent report from Reuters Health highlights results from a new study which found that the less education people have, the greater their risk of eventually developing chronic heart failure.

Researchers say lower education levels are basically a stand-in for people’s overall economic condition, and that their findings add to evidence connecting poverty to heart disease.

The results, they add, also suggest that heart failure prevention for lower income people needs to begin early in life.

Heart failure is a chronic condition in which the heart can no longer pump efficiently enough to meet the body’s demands, causing symptoms like fatigue, breathlessness and fluid buildup in the limbs.

Coronary heart disease (blockages in the heart arteries) is the underlying cause of about half of heart failure cases. Other major causes include damage to the heart from uncontrolled high blood pressure or diabetes.

A number of studies have found that people with lower incomes and less education have higher rates of coronary heart disease. But little has been known about their risk for heart failure.

The new study, which followed more than 18,600 Danish adults for two decades, found that those with the most education — more than 10 years of schooling — were 39 percent less likely to be admitted to a hospital for chronic heart failure than those with the least education, defined as fewer than eight years.

Men and women whose education levels were in between also fell in between when it came to heart failure risk. They were 25 percent less likely than less-educated counterparts to be hospitalized for the condition.

The findings, published in the European Heart Journal, do not prove that lower education, itself, is the reason for the elevated risks.

However, the researchers did account for a number of lifestyle-related factors — like participants’ weight, smoking habits, cholesterol levels and exercise levels — and found that there was still a link between education and heart failure hospitalizations.

 

Modern lifestyles increasing risk of NCDs

Modern lifestyles and demographic changes are increasing the risk of noncommunicable diseases (NCDs): cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.  Each year they account for 60% of all deaths or some 35 million people. (Source:  World Health Organization)

The four most prominent NCDs – cardiovascular diseases, cancer, diabetes and chronic lung diseases – were recognized as the key health priority in the WHO European Region at a recent WHO European Region meeting.  NCDs account for 77% of the disease burden and 86% of all deaths in the 53 countries in the WHO European Region.

The WHO notes that in addition to their impact on public health, NCDs constitute an economic burden, with health care costs, lost working time, and early death and disability threatening economic growth and productivity.

Clot drug to help AF patients

Hundreds of thousands of heart patients would benefit from new type of blood thinning drug to cut their risk of stroke, say UK experts (BBC News).  Patients with atrial fibrillation (AF), an erratic and sometimes fast heartbeat, can reduce their risk by a fifth when taking rivaroxaban rather than the most popular existing treatment, warfarin.

One in five people over the age of 70 is likely to be diagnosed with an irregular heartbeat, which can lead to blood clots and cause strokes.  AF affects around 800,000 UK people and is equally prevalent in Canada, United States and many other developed countries.

Access to these new therapies can often be a challenge for patients, however.  Professor Peter Weissberg, medical director at the British Heart Foundation, said: “The rate at which these new drugs are introduced into routine clinical practice will be determined by the extent to which regulators believe their benefits justify their additional cost.”

The data comes from a study of 14,000 patients and was presented at the American Heart Association conference.

10 facts about chronic disease

Ten facts (from the World Health Organization) about chronic disease

1. Chronic disease is responsible for 60% of all deaths worldwide
2. 80% of chronic disease deaths occur in low and middle income countries
3. Almost half of chronic disease deaths occur in people under the age of 70
4. Around the world, chronic disease affects women and men almost equally
5. The major risk factors for chronic disease are an unhealthy diet, physical inactivity, and tobacco use
6. Without action, 17 million people will die prematurely this year from a chronic disease
7. One billion adults are overweight – without action, this figure will surpass 1.5 billion by 2015
8. 22 million children under five years old are overweight
9. Tobacco use causes at least five million deaths each year
10. If the major risk factors for chronic disease were eliminated, at least 80% of heart disease, stroke and type 2 diabetes would be prevented; and 40% of cancer would be prevented

CDC estimates 1 in 3 adults could have diabetes by 2050

As many as 1 in 3 U.S. adults could have diabetes by 2050 if current trends continue, according to a new analysis from the Centers for Disease Control and Prevention.

One in 10 U.S. adults has diabetes now. The prevalence is expected to rise sharply over the next 40 years due to an aging population more likely to develop type 2 diabetes, increases in minority groups that are at high risk for type 2 diabetes, and people with diabetes living longer, according to CDC projections published in the journal Population Health Metrics.

Diabetes was the seventh leading cause of death in 2007, and is the leading cause of new cases of blindness among adults under age 75, kidney failure, and non-accident/injury leg and foot amputations among adults. People with diagnosed diabetes have medical costs that are more than twice that of those without the disease. The total costs of diabetes are an estimated $174 billion annually, including $116 billion in direct medical costs.

Proper diet and physical activity can reduce the risk of diabetes and help to control the condition in people with diabetes. Effective prevention programs directed at groups at high risk of type 2 diabetes can considerably reduce future increases in diabetes prevalence, but will not eliminate them, the report says.

The projection that one-third of all U.S. adults will have diabetes by 2050 assumes that recent increases in new cases of diabetes will continue and people with diabetes will also live longer, which adds to the total number of people with the disease.

An estimated 285 million people worldwide had diabetes in 2010, according to the International Diabetes Federation. The federation predicts as many as 438 million will have diabetes by 2030.

Burden of NCDs in India – estimated USD 237 billion in lost national income (2006-15)

The Cameron Institute – a not-for-profit, public policy think tank — recently released an analysis of the economic impact of non-communicable diseases in India.

As of 2005, India experienced the “highest loss in potentially productive years of life” worldwide, according to an article published in The Lancet.The projected cumulative loss of national income for India due to non-communicable disease mortality for 2006-2015 will be USD237 billion. By 2030, this productivity loss was expected to double to 17.9 million years lost – almost 1,000% greater than the corresponding loss in the United States, which has a population a third the size of India’s.

Download and read the entire report.

63rd WHA – update on discussions

The sixty-third World Health Assembly is coming to a close later today.  Some of the key issues raised at this year’s meeting included progress towards the Millenium Development Goals, counterfeit medicines, prevention of non-communicable diseases and the Global Strategy on public health, innovation and intellectual property.  The following is a brief overview from these discussions.

Millenium Development Goals (MDGs)

Experts from WHO, member countries and the Global Fund provided a progress update on the health-related MDGs and highlighted key challenges remaining.

Noting the impact of the financial crisis on health, participants emphasized the importance of sustaining investments in health.

Speakers highlighted the need for better coordination of funding mechanisms, global financing aligning with local priorities and national health plans, and mutual accountability for both the donors and the receiving governments.

Participants called for renewed action to achieve the health-MDGs.

Prevention and control of non-communicable diseases (NCDs)

NCDs cause 60% of all deaths worldwide, with 80% occurring in low and middle-income countries.

Noncommunicable diseases – mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes – kill nearly 35 million people per year. Almost 90% of fatalities before the age of 60 occur in developing countries and are largely preventable.

Highlighted the changing health profiles of countries and the need to focus attention on the emerging priority of NCDs and their burden on the population and health care spending.

Counterfeit Medicines

The proliferation of potentially lethal or harmful counterfeit medicines has been on the rise, particularly with the increased usage of the Internet worldwide.

WHO will not drop use of the term ‘counterfeit’ to describe fake medicines despite generic producing nations complaints about possible confusion over the term.

“With substandard medicines, drug regulatory authorities know who to go to when a quality problem is discovered,” said Hans Hogerzeil, the director of the WHO programme on Medicines Policy and Standards. “But with counterfeit, false or fake medicines the identity of the producer is not known, and they easily cross national borders, so normal regulatory approaches cannot be used.”

“Every honest industry is interested in stopping this,” said Hogerzeil, as is every government because counterfeiting harms both patients and the legitimacy of the health system.”

Public health, innovation and intellectual property

Delegates discussed a global strategy and plans of action for public health, innovation and intellectual property. The debate focused on financing issues, including the rational use of funds, and conducting research through regional networks.

The item will be taken up for discussion later in the week.

Global eradication of measles

Approximately 20 delegates took the floor and endorsed targets set for 2015 as milestones towards the eventual global eradication of measles.

Success in achieving the measles 2015 targets is essential if the MDG 4 – reduce child mortality – is to be reached.

Food Safety

Many countries noted that diseases can be caused by unsafe food, that national food production systems are susceptible food safety problems and that more food is traded across borders then ever before.

WHO was encouraged to continue working directly with Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE) to strengthen public health, support economic development, and continue joint risk assessments through WHO/FAO expert bodies, and establish standards through the FAO/WHO Codex Alimentarius Commission.