Publications by authors named "Tania Riddell"
Aim: In Aotearoa, New Zealand, cardiovascular disease (CVD) burden is greatest among Indigenous Māori, Pacific and Indian people. The aim of this study was to describe CVD risk profiles by ethnicity.
Methods: We conducted a cross-sectional analysis of a cohort of people aged 35-74 years who had a CVD risk assessment in primary care between 2004 and 2016.
Background: Most cardiovascular disease risk prediction equations in use today were derived from cohorts established last century and with participants at higher risk but less socioeconomically and ethnically diverse than patients they are now applied to. We recruited a nationally representative cohort in New Zealand to develop equations relevant to patients in contemporary primary care and compared the performance of these new equations to equations that are recommended in the USA.
Methods: The PREDICT study automatically recruits participants in routine primary care when general practitioners in New Zealand use PREDICT software to assess their patients' risk profiles for cardiovascular disease, which are prospectively linked to national ICD-coded hospitalisation and mortality databases.
Introduction: National cardiovascular disease (CVD) guidelines recommend that adults have cholesterol levels monitored regularly. However, little is known about the extent and equity of cholesterol testing in New Zealand.
Aim: To investigate the distribution and frequency of blood lipid testing by sociodemographic status in Auckland, New Zealand.
Background: Triple therapy with anti-platelet/anti-coagulant, blood pressure (BP)-lowering, and statin medications improves outcomes in atherosclerotic cardiovascular disease (CVD). However, in practice there is often a substantial evidence-practice gap, with sub-optimal initiation and longer-term adherence. Our aim was to enumerate a contemporary national cohort of people with significant CVD and report the variation in CVD secondary prevention dispensing by demographic variables.
View Article and Find Full Text PDFObjectives: To determine 28-day and one-year case fatality in patients hospitalised with acute coronary syndromes (ACS) and identify factors associated with mortality.
Methods: All New Zealand residents admitted with ACS between 2007 and 2009 were followed for one year using individual patient linkage of national hospitalisation and mortality datasets. Deaths from any cause were used to calculate 28-day and one-year case fatality.
Background: Prior studies have reported higher rates of coronary revascularisation in European compared with Maori and Pacific patients. Our aim was to define the current variation by ethnicity in investigation, revascularisation and pharmacotherapy after admission with an acute coronary syndrome (ACS).
Methods: Data from consecutive New Zealand residents <80 years of age admitted to the Middlemore Hospital coronary care unit with ACS (2007 to 2012) were collected prospectively.
Objective: To describe patterns of statin use and predictors of poor maintenance over a 3-year period following an acute coronary syndrome (ACS).
Methods: National hospitalisation, mortality and pharmaceutical dispensing data were linked for all subjects aged 35-84 years discharged from a public hospital with an ACS in New Zealand in 2007. A Medication Possession Ratio (MPR; percentage of follow-up days patients were dispensed statins) was calculated for each patient.
Aim: To examine whether use of a standardized cardiovascular disease (CVD) risk assessment recommended by national guidelines is associated with appropriate initiation and maintenance of medication in a large primary care cohort.
Methods And Design: A total of 90,631 people aged 30-80 years were followed for up to 3 years after a formal CVD risk assessment was undertaken between January 2006 and October 2009, during routine primary care visits in New Zealand. Patients either had prior CVD or had their CVD risk estimated using a modified Framingham prediction equation for fatal or non-fatal CVD events.
Introduction: New Zealand (NZ) guidelines recommend treating people for cardiovascular disease (CVD) risk on the basis of five-year absolute risk using a NZ adaptation of the Framingham risk equation. A diabetes-specific Diabetes Cohort Study (DCS) CVD predictive risk model has been developed and validated using NZ Get Checked data.
Aim: To revalidate the DCS model with an independent cohort of people routinely assessed using PREDICT, a web-based CVD risk assessment and management programme.
Objective: To compare the cardiovascular disease (CVD) risk profiles of Indian and European patients from routine primary care assessments in the northern region of New Zealand.
Method: Anonymous CVD risk profiles were extracted from PREDICT (a web-based decision support program) for Indian and European patients aged 35-74 years. Linear regression models were used to obtain mean differences adjusted for age, gender and deprivation.
Aim: To estimate sociodemographic differences in the prevalence of coronary heart disease (CHD) in New Zealand from linked health records.
Methods: We combined records of hospital treatment for CHD, dispensing of selected anti-anginal drugs and mortality to estimate the national point prevalence of coronary heart disease in New Zealand in December 2008. Stratified estimates are presented by gender; age; Māori, Pacific, Indian and 'Other' (mainly New Zealand European) ethnic groups; and socioeconomic status.
Introduction: Blood pressure-lowering (BPL) and lipid-lowering (LL) medications together reduce estimated absolute five-year cardiovascular disease (CVD) risk by >40%. International studies indicate that the proportion of people with CVD receiving pharmacotherapy increases with advancing age.
Aim: To compare BPL and LL medications, by sociodemographic characteristics, for patients with known CVD in primary care settings.
Background: Data on the cardiovascular disease risk profiles of Pacific peoples in New Zealand is usually aggregated and treated as a single entity. Little is known about the comparability or otherwise of cardiovascular disease (CVD) risk between different Pacific groups.
Aim: To compare CVD risk profiles for the main Pacific ethnic groups assessed in New Zealand primary care practice to determine if it is reasonable to aggregate these data, or if significant differences exist.
Background: Ischaemic Heart Disease (IHD) is a leading cause of death in New Zealand and the burden falls disproportionately on Māori, the indigenous population of Aotearoa New Zealand.
Methods: Data for Māori:non-Māori disparities in risk factors, hospitalisation, procedure receipt and mortality for IHD are analysed. Age-adjusted rates of IHD mortality (2000-2004) and publicly funded hospitalisations and procedures (2003-2005) for Māori and non-Māori are reported and compared.
Aim: This study estimated diabetes prevalence and utilisation of healthcare services in Counties Manukau using routinely collected administrative data and compared estimates with findings for three other district health boards (DHBs) in close geographic proximity.
Method: Records of subsidy claims for pharmaceuticals and laboratory investigations were linked to records in a national hospital admissions database to 'reconstruct' populations of four DHBs--Counties Manukau, Northland, Waitemata and Auckland. Individuals were included in reconstructed populations if they had health events recorded between January 2006 and December 2007.
The challenges and opportunities for provision of, and access to, reliable chronic cardiovascular health care for Indigenous people were addressed by expert speakers from New Zealand and Australia. It is well recognised that cardiovascular disease is a life-long concern, requiring reliable follow-up, early transition of clinical research into practice and ongoing support of patients. The clinical outcomes and long-term prognosis of individuals with cardiovascular disease are critically dependent upon the quality and availability of follow-up and chronic care facilities.
View Article and Find Full Text PDFRates of acute rheumatic fever and chronic rheumatic heart disease in Aboriginal people, Torres Strait Islanders and Māori continue to be unacceptably high. The impact of rheumatic heart disease is inequitable on these populations as compared with other Australians and New Zealanders. The associated cardiac morbidity, including the development of rheumatic valve disease, and cardiomyopathy, with possible sequelae of heart failure, development of atrial fibrillation, systemic embolism, transient ischaemic attacks, strokes, endocarditis, the need for interventions including cardiac surgery, and impaired quality of life, and shortened life expectancy, has major implications for the individual.
View Article and Find Full Text PDFAim: To investigate the differences in the baseline cardiovascular disease (CVD) risk profiles of Pacific peoples and Europeans assessed in routine primary care practice by PREDICT, a web-based clinical decision support programme for assessing and managing CVD risk.
Methods: PREDICT has been implemented in primary care practices from nine consenting PHOs in Auckland and Northland. Between 2002 and January 2009, over 70,000 CVD risk assessments were conducted.
Aim: To compare the calibration performance of the original Framingham Heart Study risk prediction score for cardiovascular disease and an adjusted version of the Framingham score used in current New Zealand cardiovascular risk management guidelines for high and low risk ethnic groups.
Methods: Since 2002 cardiovascular risk assessments have been undertaken as part of routine clinical care in many New Zealand primary care practices using PREDICT, a web-based decision support programme for assessing and managing cardiovascular risk. Individual risk profiles from PREDICT were electronically and anonymously linked to national hospital admissions and death registrations in January 2008.
The burden of coronary heart disease in Māori: population-based estimates for 2000-02.
Aust N Z J Public Health
August 2009
Objective: To estimate coronary heart disease (CHD) incidence, prevalence, survival, case fatality and mortality for Māori, in order to support service planning and resource allocation.
Methods: Incidence was defined as first occurrence of a major coronary event, i.e.