Comparison of Secondary Prevention in Patients with Coronary Heart Disease Living in Rural and Urban Areas [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-68782 | DOI: 10.5543/tkda.2018.68782

Comparison of Secondary Prevention in Patients with Coronary Heart Disease Living in Rural and Urban Areas

Salih Kilic1, Erhan Saracoglu1, Yusuf Cekici1, Arafat Yildirim1, Zülfiye Kuzu1, Dilara Deniz Kilic2, Meral Kayikcioglu3
1Doctor Ersin Arslan Training and Research Hospital, Department of Cardiology, Gaziantep, Turkey
2Nizip State Hospital, Department of Internal Medicine, Gaziantep, Turkey
3Ege University Faculty of Medicine, Department of Cardiology, İzmir


OBJECTIVES
Present study aimed to determine differences between urban and rural patients with coronary heart disease (CHD) with respect to secondary prevention.

METHODS
This cross-sectional study included all consecutive patients diagnosed with CHD in two different cardiology clinics between January 2016 and January 2017. The demographic characteristics and laboratory parameters were recorded at routine controls. Based on their declaration patients were divided into two groups according to their residence; urban (n=1752) and rural (n=456).

RESULTS
Median age of patients were 64 (IQR 12). A mean of 4.1±2.1 years passed after the first (index) coronary event. We found that 22.2% of patients continued smoking, and the rate of quitting was significantly higher in urban group (20.5% vs. 11.2%; p<0.001). Hypertension (64.3% vs. 56.7%), diabetes mellitus (45.6% vs. 39.2), cerebrovascular events (9.2% vs. 3.8%), and chronic obstructive pulmonary disease (11.4% vs. 5.5%) were all significantly higher in rural patients (p<0.05 for all). In all, 34.2% were obese, and the number of obese patients were significantly higher in rural patients than in urban patients (46.4% vs. 31.2%; p<0.001). The number of patients performing regular exercise was significantly lower in rural patients (34.4% vs. 23.9%; p<0.001). Overall, 88.9% of patients received antiplatelet agents; 62.1%, statins; 73.1%, beta-blockers; and 34.2%, ACEI/ARBs. The rate of receiving medication was significantly higher in urban patients than in rural patients (p<0.05 in all cases).

CONCLUSION
Secondary prevention among patients with CHD requires further improvement. Moreover, secondary prevention in the rural population is worse than that in the urban population.

Keywords: Secondary prevention, urban, rural, coronary heart disease

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Corresponding Author: Salih Kilic, Türkiye
© Copyright 2018 Archives of the Turkish Society of Cardiology
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