Understanding and managing cardiovascular disease risk factors in Vietnam: integrating clinical and public health perspectives
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Background: Vietnam, like other low-income countries, is facing an epidemic burden of cardiovascular disease risk factors (CVDRFs). The magnitude and directions of CVDRF progression are matters of uncertainty.
Objectives: To describe the epidemiological progression of CVDRFs and the preventive effects of community lifestyle interventions, with reference to the differences in progression of CVDRF patterns between men and women.
Methods: The study was conducted during 2001-2009 in nationally representative samples and in a local setting of rural areas of Ba-Vi district, Ha-Tay province. Both epidemiological and interventional approaches were applied: (i) a population-based cross-sectional survey of 2,130 people aged ≥25 years in Thai-Binh and Hanoi; (ii) an individual participant-level meta analysis of 23,563 people aged 24-74 years from multiple similar surveys in 9 provinces around Vietnam; (iii) a 17-month cohort study of 497 patients in a hypertension management programme; (iv) a quasi-experimental trial on community lifestyle promotion integrated with a hypertension management programme, evaluated by surveys of 4,645 people in both intervention and reference communes before and after a 3-year intervention.
Main findings: (i) in the general adult population ≥25 years, CVDRFs were common, often clustered within individuals, and increased with age; (ii) the Vietnamese population is facing a growing epidemic of CVDRFs, which are generally not well managed; (iii) it is possible to launch a community intervention in low-resource settings within the scope of a commune-based patient-targeted programme on hypertension management; (iv) community health intervention with comprehensive healthy lifestyle promotion improves blood pressure and some behavioural CVDRFs.
Conclusion: Alarming increases in CVDRFs in the general population need comprehensive multi-level prevention strategies, which combine both individual high-risk and population health approaches. The commune-based hypertension-centred management programmes integrated with community health promotion are the initial but essential steps towards comprehensive and effective management of CVDRFs and should be part of an integrated and co-ordinated national program on the prevention and control of chronic diseases in low-resource settings like Vietnam.
Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2012. , 62 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1498
cardiovascular disease risk factors, epidemiology, prevention, hypertension, Vietnam
yếu tố nguy cơ bệnh tim mạch, dịch tễ học, dự phòng, tăng huyết áp, Việt Nam
Public Health, Global Health, Social Medicine and Epidemiology
Research subject Cardiology
IdentifiersURN: urn:nbn:se:umu:diva-55132ISBN: 978-91-7459-420-1OAI: oai:DiVA.org:umu-55132DiVA: diva2:525680
2012-06-01, Room 135, Family Medicine, Umeå University Hospital, Umeå, Sweden, 13:00 (English)
Bondjers, Göran, Professor
Byass, Peter, ProfessorNguyen, Lan-Viet, ProfessorWall, Stig, ProfessorWeinehall, Lars, ProfessorBonita, Ruth, Professor
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