Primary and Secondary Cardiovascular Prevention Among First Nations Peoples With Type 2 Diabetes in Canada: Findings From the FORGE AHEAD Program
Background: First Nations (FN) peoples in Canada face spiraling rates of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Data on the extent of CVD risk-factor management in FN peoples with T2DM in Canada are scarce. Methods: A T2DM registry with data from 7 FN communities in Canada...
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ftdoajarticles:oai:doaj.org/article:1916701805364cd79beb0574d9479a51 2023-05-15T16:16:11+02:00 Primary and Secondary Cardiovascular Prevention Among First Nations Peoples With Type 2 Diabetes in Canada: Findings From the FORGE AHEAD Program Romina Pace, MD, MSc Stewart Harris, MD, MPH Monica Parry, NP-Adult, MEd, MSc, PhD Harsh Zaran, MGA 2020-11-01T00:00:00Z https://doi.org/10.1016/j.cjco.2020.07.004 https://doaj.org/article/1916701805364cd79beb0574d9479a51 EN eng Elsevier http://www.sciencedirect.com/science/article/pii/S2589790X20300986 https://doaj.org/toc/2589-790X 2589-790X doi:10.1016/j.cjco.2020.07.004 https://doaj.org/article/1916701805364cd79beb0574d9479a51 CJC Open, Vol 2, Iss 6, Pp 547-554 (2020) Diseases of the circulatory (Cardiovascular) system RC666-701 article 2020 ftdoajarticles https://doi.org/10.1016/j.cjco.2020.07.004 2022-12-31T15:46:11Z Background: First Nations (FN) peoples in Canada face spiraling rates of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Data on the extent of CVD risk-factor management in FN peoples with T2DM in Canada are scarce. Methods: A T2DM registry with data from 7 FN communities in Canada was utilized to identify individuals eligible for primary and secondary CVD prevention. Proportions of individuals meeting clinical practice guideline–specified targets (hemoglobin A1c ≤7.0%; blood pressure ≤130/80 mm Hg; low-density lipoprotein ≤2 mmol/L) were calculated. Prescription of recommended cardioprotective medications (antithrombotic medication, lipid-lowering agents, renin-angiotensin-aldosterone system inhibitors, and beta-blockers) among those with CVD was assessed. χ2 tests were employed to evaluate differences between CVD prevention groups and sexes. Results: Of the 2098 individuals in the registry, 18% had documented CVD (female: male = 1.12). Overall, <10% met all 3 clinical practice guideline targets. Attainment of hemoglobin A1c and blood pressure targets was comparable between primary and secondary CVD prevention groups, with<50% achieving targets. A greater proportion of the secondary prevention group met low-density lipoprotein targets compared to those without CVD (61.6% vs 40.9%, P < 0.01). In the secondary prevention group, beta-blockers were prescribed to only 20%, and <60% were prescribed antithrombotics, lipid-lowering medications, or agents targeting the renin-angiotensin-aldosterone system; <2% were prescribed medications from all 4 classes of cardioprotective medications. Conclusions: Primary and secondary CVD prevention recommendations for individuals with T2DM are not being met for an alarmingly high proportion of FN peoples. These findings serve as an urgent call for proactive measures to reduce CVD events and related mortality in this high-risk population. Résumé: Contexte: Au Canada, chez les membres des Premières Nations, le nombre de cas de diabète de type 2 (DT2) ... Article in Journal/Newspaper First Nations Premières Nations Directory of Open Access Journals: DOAJ Articles Canada CJC Open 2 6 547 554 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Diseases of the circulatory (Cardiovascular) system RC666-701 |
spellingShingle |
Diseases of the circulatory (Cardiovascular) system RC666-701 Romina Pace, MD, MSc Stewart Harris, MD, MPH Monica Parry, NP-Adult, MEd, MSc, PhD Harsh Zaran, MGA Primary and Secondary Cardiovascular Prevention Among First Nations Peoples With Type 2 Diabetes in Canada: Findings From the FORGE AHEAD Program |
topic_facet |
Diseases of the circulatory (Cardiovascular) system RC666-701 |
description |
Background: First Nations (FN) peoples in Canada face spiraling rates of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Data on the extent of CVD risk-factor management in FN peoples with T2DM in Canada are scarce. Methods: A T2DM registry with data from 7 FN communities in Canada was utilized to identify individuals eligible for primary and secondary CVD prevention. Proportions of individuals meeting clinical practice guideline–specified targets (hemoglobin A1c ≤7.0%; blood pressure ≤130/80 mm Hg; low-density lipoprotein ≤2 mmol/L) were calculated. Prescription of recommended cardioprotective medications (antithrombotic medication, lipid-lowering agents, renin-angiotensin-aldosterone system inhibitors, and beta-blockers) among those with CVD was assessed. χ2 tests were employed to evaluate differences between CVD prevention groups and sexes. Results: Of the 2098 individuals in the registry, 18% had documented CVD (female: male = 1.12). Overall, <10% met all 3 clinical practice guideline targets. Attainment of hemoglobin A1c and blood pressure targets was comparable between primary and secondary CVD prevention groups, with<50% achieving targets. A greater proportion of the secondary prevention group met low-density lipoprotein targets compared to those without CVD (61.6% vs 40.9%, P < 0.01). In the secondary prevention group, beta-blockers were prescribed to only 20%, and <60% were prescribed antithrombotics, lipid-lowering medications, or agents targeting the renin-angiotensin-aldosterone system; <2% were prescribed medications from all 4 classes of cardioprotective medications. Conclusions: Primary and secondary CVD prevention recommendations for individuals with T2DM are not being met for an alarmingly high proportion of FN peoples. These findings serve as an urgent call for proactive measures to reduce CVD events and related mortality in this high-risk population. Résumé: Contexte: Au Canada, chez les membres des Premières Nations, le nombre de cas de diabète de type 2 (DT2) ... |
format |
Article in Journal/Newspaper |
author |
Romina Pace, MD, MSc Stewart Harris, MD, MPH Monica Parry, NP-Adult, MEd, MSc, PhD Harsh Zaran, MGA |
author_facet |
Romina Pace, MD, MSc Stewart Harris, MD, MPH Monica Parry, NP-Adult, MEd, MSc, PhD Harsh Zaran, MGA |
author_sort |
Romina Pace, MD, MSc |
title |
Primary and Secondary Cardiovascular Prevention Among First Nations Peoples With Type 2 Diabetes in Canada: Findings From the FORGE AHEAD Program |
title_short |
Primary and Secondary Cardiovascular Prevention Among First Nations Peoples With Type 2 Diabetes in Canada: Findings From the FORGE AHEAD Program |
title_full |
Primary and Secondary Cardiovascular Prevention Among First Nations Peoples With Type 2 Diabetes in Canada: Findings From the FORGE AHEAD Program |
title_fullStr |
Primary and Secondary Cardiovascular Prevention Among First Nations Peoples With Type 2 Diabetes in Canada: Findings From the FORGE AHEAD Program |
title_full_unstemmed |
Primary and Secondary Cardiovascular Prevention Among First Nations Peoples With Type 2 Diabetes in Canada: Findings From the FORGE AHEAD Program |
title_sort |
primary and secondary cardiovascular prevention among first nations peoples with type 2 diabetes in canada: findings from the forge ahead program |
publisher |
Elsevier |
publishDate |
2020 |
url |
https://doi.org/10.1016/j.cjco.2020.07.004 https://doaj.org/article/1916701805364cd79beb0574d9479a51 |
geographic |
Canada |
geographic_facet |
Canada |
genre |
First Nations Premières Nations |
genre_facet |
First Nations Premières Nations |
op_source |
CJC Open, Vol 2, Iss 6, Pp 547-554 (2020) |
op_relation |
http://www.sciencedirect.com/science/article/pii/S2589790X20300986 https://doaj.org/toc/2589-790X 2589-790X doi:10.1016/j.cjco.2020.07.004 https://doaj.org/article/1916701805364cd79beb0574d9479a51 |
op_doi |
https://doi.org/10.1016/j.cjco.2020.07.004 |
container_title |
CJC Open |
container_volume |
2 |
container_issue |
6 |
container_start_page |
547 |
op_container_end_page |
554 |
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1766002035202719744 |