Publications by authors named "Capewell S"
Background: Recent, dramatic increases in coronary heart disease (CHD) mortality in China can be mostly explained by adverse changes in major cardiovascular risk factors. Our study aimed to assess the potential impact of subsequent changes in risk factors and population ageing on CHD deaths in Beijing between 1999 and 2010.
Methods: The previously validated IMPACT model was used to estimate the CHD deaths expected in 2010, with treatment uptakes being held constant at levels measured in 1999, comparing three scenarios: a) taking into account the ageing of the population but assuming no further changes in major risk factor levels from 1999 or, b) if recent risk factor trends continued until 2010 or, c) if there was a 0.
Background: We examined whether population-level hospitalization rates for heart failure (HF) and subsequent survival have continued to improve since the turn of the century. We also examined trends in the prescribing of evidence-based pharmacological treatment for HF.
Methods And Results: All patients in Scotland hospitalized with a first episode of HF between 1986 and 2003 were followed up until death or the end of 2004.
Aims: Coronary heart disease (CHD) mortality rates have been falling in Sweden since the 1980s. We used the previously validated IMPACT CHD model to examine how much of the mortality decrease in Sweden between 1986 and 2002 could be attributed to medical and surgical treatments, and how much to changes in cardiovascular risk factors.
Methods And Results: The IMPACT mortality model was used to combine and analyse data on uptake and effectiveness of cardiological treatments and risk factor trends in Sweden.
Background: Policymakers must be able to calculate the comparative effectiveness of interventions to control heart disease if they are to optimize the population impact of programmatic initiatives.
Methods: A model was created to calculate the number of deaths that would be prevented or postponed if perfect care for heart disease prevention and treatment were achieved--that is, the elimination of risk factors and the prescription of all effective medications before and between acute events, and the delivery of all effective therapies to individuals suffering an acute heart disease event. The impact of perfect care was calculated for a hypothetic population aged 30-84 years with risk-factor levels, event rates, current patterns of behavior, levels of treatment, and mortality rates resembling those of the U.
Background: In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making.
Methods: Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations.
Objective: Coronary heart disease (CHD) is associated with a large burden of disease in Ireland and is responsible for more than 6000 deaths annually. This study examined the cost-effectiveness of specific CHD treatments in Ireland.
Methods: Irish epidemiological data on patient numbers and median survival in specific groups, plus the uptake, effectiveness, and costs of specific interventions, all stratified by age and sex, were incorporated into a previously validated CHD mortality model, the IMPACT model.
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View Article and Find Full Text PDFObjectives: To explore attitudes to the use of models for coronary heart disease to support decision-making for policy and service planning.
Methods: Qualitative study using semi-structured interviews with 33 policy- and decision-makers purposively sampled from the UK National Health Service (NHS) (national, regional and local levels), academia and voluntary organizations. Interviews were transcribed, coded and emergent themes identified using framework analysis aided by NVivo software.
The research base of palliative care is growing rapidly, but despite methodological advances, some of the practical challenges of working with people at the end of life will persist. This means that analysis of routine data is arguably more important in studying palliative care than it is in other aspects of health services research. End-of-life researchers have been using the high-quality linked data from cancer registries for many years.
View Article and Find Full Text PDFObjective: To examine the potential public health impact on CHD and stroke mortality of replacing one 'unhealthy' snack with one 'healthy' snack per person, per day, across the UK population.
Methods: Nutritional information was obtained for different 'unhealthy' (such as crisps, chocolate bars, cakes and pastries) and 'healthy' snack products (such as fresh fruit, dried fruit, unsalted nuts or seeds). Expected changes in dietary intake were calculated.
Objective: To estimate the burden of cardiovascular disease within 15 European Union countries (before the 2004 enlargement) as a result of excess dietary saturated fats attributable to the Common Agricultural Policy (CAP).
Methods: A spreadsheet model was developed to synthesize data on population, diet, cholesterol levels and mortality rates. A conservative estimate of a reduction in saturated fat consumption of just 2.
We used the previously validated IMPACT coronary heart disease (CHD) mortality model to estimate the CHD deaths attributable to reductions in smoking prevalence following the introduction of the Massachusetts Tobacco Control Program (MTCP) in 1993. A 29% and 31% decline in smoking prevalence and CHD mortality rates occurred, respectively (from 1993 to 2003). A total of 425 fewer CHD deaths, which generated approximately 3365 extra life-years, were attributable to decreased smoking prevalence.
View Article and Find Full Text PDFBackground: Coronary heart disease (CHD) rates in England and Wales between 1950 and 2005 were high and reasonably steady until the mid 1970s, when they began to fall. Recent work suggests that the rate of change in some groups has begun to decrease and may be starting to plateau or even reverse.
Methods: Data for all deaths between 1931 and 2005 in England and Wales were grouped by year, sex, age at death and contemporaneous ICD code for CHD as cause of death.
Aim: This paper is a report of a study to examine the complexities of informal caregiving for people with chronic heart failure.
Background: Little is known of the activities involved and underlying informal care. Heart failure is a common and burdensome condition in which carers play an important management role.
Background: The incidence of myocardial infarction (MI) in Britain has fallen markedly in recent years. Few studies have investigated the extent to which this decline can be explained by concurrent changes in major cardiovascular risk factors.
Methods And Results: The British Regional Heart Study examined changes in cardiovascular risk factors and MI incidence over 25 years from 1978 in a cohort of 7735 men.
Objectives: The objective of our study was to examine age-specific mortality rates from coronary heart disease (CHD), particularly those among younger adults.
Background: Trends for obesity, diabetes, blood pressure, and metabolic syndrome among young adults raise concerns about the mortality rates from CHD in this group.
Methods: We used mortality data from 1980 to 2002 to calculate age-specific mortality rates from CHD for U.
Objective: To determine whether introducing chest pain unit care reduces emergency admissions without increasing reattendances and admissions over the next 30 days.
Design: Cluster randomised before and after intervention trial.
Setting: 14 diverse acute hospitals in the United Kingdom.
Background: Trends in cardiovascular risk factors among UK adults present a complex picture. Ominous increases in obesity and diabetes among young adults raise concerns about subsequent coronary heart disease (CHD) mortality rates in this group.
Objective: To examine recent trends in age-specific mortality rates from CHD, particularly those among younger adults.
Background: To investigate whether primary prevention might be more favourable than secondary prevention (risk factor reduction in patients with coronary heart disease(CHD)).
Methods: The cell-based IMPACT CHD mortality model was used to integrate data for Ireland describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in CHD patients and in healthy people without recognised CHD.
Results: Between 1985 and 2000, approximately 2,530 fewer deaths were attributable to reductions in the three major risk factors in Ireland.