Introduction
Cardiometabolic, behavioral, environmental, and social risk factors are the main drivers of ischemic heart disease. Consistent, comparable and systematic analysis of long-term trends and patterns in cardiovascular disease (CVD) globally is essential to guide public policy and provide benchmarks for health decision-makers [1].
Ischemic heart disease (IHD) is a major public concern and is the leading cause of mortality and morbidity worldwide, including acute myocardial infarction (AMI), chronic IC (angina, asymptomatic IC after myocardial infarction), and ischemic heart failure [2]. In 2019, IHD was responsible for more than 182 million disability-adjusted life years and 9.14 million deaths [3], while coronary heart disease causes catastrophic health expenditures across countries and regions.
In the United States of America, heart disease is projected to increase by 41 percent, and with it health care spending, reaching $177.5 billion by 2040 [4]. Germany, the United States and Brazil are the countries with the highest CVD mortality rates (37.62%, 31.57% and 28.78%, respectively) [5].
In many countries including the United States of America, smoking has declined dramatically, from more than 40% of adults in the mid-1960s to ≈11% today. However, after decades of declining CVD rates, the most recent trends are increasing, attributed in part to worsening risk factors such as diabetes, an aging population, health disparities, and other factors [6].
In a study carried out in four South American countries (Colombia, Chile, Argentina and Brazil) it was shown that the main causes of death were CVD (31.1%), cancer (30.6%) and respiratory diseases (8.6%) and represent more than two-thirds of deaths in South America. For CVD, the main FAPs were due to arterial hypertension (HTN) (18.7%), abdominal obesity (15.4%), smoking (13.5%), low muscle strength (5.6%) and diabetes (5.3%). For mortality, the main FAPs were smoking (14.4%), hypertension (12.0%), low schooling (10.5%), abdominal obesity (9.7%), and diabetes (5.5%) [7].
In recent years, substantial reductions in the prevalence of CVD have been achieved by attenuating risk factors (particularly hypertension and dyslipidemias) in primary and secondary prevention. Despite the remarkable success of lipid-lowering therapies in reducing the risk of CVD, there is still an unmet clinical need to achieve recommended lipid targets in even 2/3 of patients [8].
Another risk factor described is the sex of the population, heart failure affects millions of people, although women have better overall survival rates, they also suffer greater morbidity, as evidenced by higher rates of hospitalization and a worse quality of life [9].
For the aforementioned reasons, this work aims to characterize the inhabitants with ischemic heart disease of the Cacahual Family Medical Office in the period from January to December 2023.
Methods
A descriptive and cross-sectional study was carried out in residents with ischemic heart disease at the Cacahual Family Medical Office in the municipality of Sancti Spíritus, in the period from January to December 2023.
The universe was made up of all the inhabitants with ischemic heart disease who live in the town of Cacahual in the period between January and December 2023. The sample consisted of 106 inhabitants with ischemic heart disease who met the inclusion criteria through simple random sampling.
To achieve our objective, an instrument was developed that collected the variables selected for the research, such as: age group and sex, risk factors and age group, risk factors and sex, personal pathological history, nutritional evaluation and smoking habit (corresponding numbers and percentages).
The data were processed manually, tabulated according to the individual counting method. The data obtained were presented in tables, which allowed comparison analysis with other studies.
The research was approved by the Research Ethics Committee and the Scientific Council of the Camilo Cienfuegos General Hospital and the University of Medical Sciences of Sancti Spíritus. The graduates signed an informed consent form to accept their participation in the study, as well as the state of agreement of their relatives through a written document, with the commitment by the authors that the information obtained would be used only for research purposes without revealing personal data of the graduates.
Results
It is shown that males (83.01 %) had a greater predominance than females (16.98 %). The age group with the highest relevance was 20 to 29 years old (42.45%) (Table 1).
Table 1: Distribution of patients with ischemic heart disease at the Cacahual Family Medical Office by age group and sex
|
Age group
|
Sexes
|
|
Female
|
Male
|
Total
|
|
No.
|
%
|
No.
|
%
|
No.
|
%
|
|
Ages 20 to 29
|
13
|
12,26
|
32
|
30,18
|
45
|
42,45
|
|
From 30 to 39 years old
|
3
|
2,83
|
26
|
24,52
|
29
|
27,35
|
|
From 40 to 49 years old
|
2
|
1,88
|
26
|
24,52
|
28
|
26,41
|
|
From 50 to 59 years old
|
2
|
1,88
|
2
|
1,88
|
4
|
3,77
|
|
Total
|
18
|
16,98
|
88
|
83,01
|
106
|
100
|
Source: Patient Survey
In the comparison between risk factors and age group, it is found that obesity (48.11%) had a higher incidence in the age groups between 30 and 39 years and between 40 and 49 years (16.03%) in the same way. In addition to this risk factor, smoking (20.75%) prevailed in second place in the age group between 40 and 49 years (10.37%) (Table 2).
Table 2: Distribution of inhabitants with ischemic heart disease at the Cacahual Family Medical Office according to age group and cardiovascular risk factor
|
Age group
|
Cardiovascular Risk Factor
|
|
Obesity
|
Smoking
|
HTA
|
Hyperlipidemia
|
|
No.
|
%
|
No.
|
%
|
No.
|
%
|
No.
|
%
|
|
20-29
|
16
|
15,09
|
5
|
4,71
|
2
|
1,88
|
-
|
-
|
|
30-39
|
17
|
16,03
|
3
|
2,83
|
5
|
4,71
|
3
|
2,83
|
|
40-49
|
17
|
16,03
|
11
|
10,37
|
10
|
9,43
|
7
|
6,60
|
|
50-59
|
1
|
0,94
|
3
|
2,83
|
4
|
3,77
|
2
|
1,88
|
|
Total
|
51
|
48,11
|
22
|
20,75
|
21
|
19,81
|
12
|
11,32
|
Source: Patient Survey
In the comparison between risk factors and sex, it was found that obesity (48.11 %) had a higher incidence, and within this risk factor, the male sex (39.62 %) prevailed over the female sex (8.49 %), in second place was smoking (20.75 %) in the male sex (18.86 %) (Table 3).
Table 3: Distribution of inhabitants with ischemic heart disease at the Cacahual Family Medical Office according to cardiovascular risk factor and sex
|
Cardiovascular Risk Factor
|
Sexes
|
|
Female
|
Male
|
Total
|
|
No.
|
%
|
No.
|
%
|
No.
|
%
|
|
Obesity
|
9
|
8,49
|
42
|
39,62
|
51
|
48,11
|
|
Smoking
|
2
|
1,88
|
20
|
18,86
|
22
|
20,75
|
|
HTA
|
3
|
2,83
|
18
|
16,98
|
21
|
19,81
|
|
Hyperlipidemia
|
1
|
0,94
|
11
|
10,37
|
12
|
11,32
|
|
Total
|
15
|
14,15
|
91
|
85,84
|
106
|
100
|
Source: Patient Survey
Within the personal pathological history, ischemic heart disease (52.83 %) was the highest number of presentations, followed by arterial hypertension (32.07 %) (Table 4).
Table 4: Distribution of inhabitants with ischemic heart disease at the Cacahual Family Medical Office according to personal pathological history
|
Personal pathological history
|
No.
|
%
|
|
High blood pressure
|
34
|
32,07
|
|
Ischemic heart disease
|
56
|
52,83
|
|
Diabetes mellitus
|
10
|
9,43
|
|
Dislipidemias
|
4
|
3,77
|
|
Cerebrovascular disease
|
2
|
1,88
|
Source: Patient Survey
In the nutritional evaluation of the graduates, exective weight (67.92 %) predominated, followed by normal weight (24.52 %). Smokers were highly relevant in this group of inhabitants (87.73%) (Table 5).
Table 5: Distribution of inhabitants with ischemic heart disease at the Cacahual Family Medical Office according to nutritional evaluation and smoking habit
|
Nutritional assessment
|
No.
|
%
|
|
Poor weight
|
8
|
7,54
|
|
Normal weight
|
26
|
24,52
|
|
Excessive weight
|
72
|
67,92
|
|
Total
|
106
|
100
|
|
|
|
Smoking
|
No.
|
%
|
|
Non-smoking
|
13
|
12,26
|
|
Smokers
|
93
|
87,73
|
|
Total
|
106
|
100
|
Source: Patient Survey
Discussion
In our study, patients aged between 20 and 29 years of age were predominant, male and with a history of ischemic heart disease and arterial hypertension. Excessive weight and smoking patients had a high incidence within the subjects studied. Obesity and smoking were highlighted as risk factors and age groups, with these parameters coinciding negatively in these factors in males.
The results of other studies are not similar to our study in terms of the age groups that prevailed, but in terms of risk factors, as reflected in Cordero et al.,[10] they conducted an observational, multicenter, cross-sectional, nationwide study of 1 018 consecutive patients treated or being followed up for acute coronary syndrome in Spain, separated into three groups, group 1 at discharge after acute coronary syndrome, group 2 at the first post-discharge visit and group 3 between one and 2 years after acute coronary syndrome. In general, men predominated (79.5%), with a mean age of 63.1 years. Compared to group 3, in group 1 there was a significantly higher percentage of patients who smoked (32.2 vs. 10.9%), consumed alcohol (28.2 vs. 19.5%), did not exercise (61.0 vs. 38.2%), or did not follow a diet (57.1 vs. 32.5%). The comorbidities that prevailed were dyslipidemia (59.8%) and grade 1 hypertension (51.7%).
On the other hand, Linares et al., [11] conducted a descriptive, cross-sectional and prospective study in the Alonso Rojas People's Council belonging to the 5 de Septiembre Polyclinic in Cienfuegos, Cuba, in the period between October 2015 and September 2019. It was observed that 58.1% of the cases were over 70 years of age and that the most affected age group was 70-79 (56.1%) followed by 60-69 years (41.4%). Among the risk factors associated with CVD, a predominance of sedentary lifestyle (75.6%) and arterial hypertension (63.4%) was found, followed by smoking (39.0%) and obesity (34.1%).
Suárez et al., [12] also conducted a descriptive and cross-sectional study on a series of 77 patients treated at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos, in the period from January to June 2021. Patients between 50-69 years of age (55.8%) and men (64.7%) predominated. More than half (51.9%) had toxic habits, of which 39 smokers and 9 consumed alcoholic beverages. Chronic non-communicable diseases were the comorbidities that predominated with 48.1%.
Zubieta et al., [13] conducted a retrospective cohort study, in which the medical records of hospitalized patients during the period between January 1, 2020 and December 31, 2021, with a diagnosis of heart failure were reviewed. Within the 148 final medical records included, it is highlighted that most of the participants were men (71.8%), the median age was seventy years, with an interquartile range (IQR) of 62-77 years. Arterial hypertension (76.21%) was the most prevalent, followed by coronary heart disease (47.09%).
Castro et al., [14] characterized the morbidity and mortality due to acute myocardial infarction in 75 patients at the Dr. Octavio de la Concepción y de la Pedraja General Teaching Hospital in Baracoa, Guantánamo, during the 2017-2019 triennium. 72.0% of the patients were men and 37.3% were between 50 and 59 years of age.
Gil et al., [15] conducted a retrospective cross-sectional descriptive study in 765 patients with acute ST-segment elevation myocardial infarction in the Cardiology Service of the Saturnino Lora Provincial Hospital in Santiago de Cuba, in the period from 2018 to 2022. The predominant sex was male (56.1%) compared to female (43.9%). The highest incidence of patients was in the age group between 77 and 84 years old (29.7%). Regarding coronary risk factors, arterial hypertension (57.1%), smoking (40.7%) and type 2 diabetes mellitus (39.0%) prevailed.
Conclusion
With the data obtained, it was possible to characterize the inhabitants with ischemic heart disease of the Cacahual Family Medical Office of Sancti Spíritus, where it has been possible to evidence the existence of young residents with this type of pathology in this area of the municipality. Modifiable risk factors were related to smoking and obesity.
Declarations
Conflict of interest
The authors declare that there are no conflicts of interest related to the study.
Financing
No funding has been received for this study.
