Evidence map›Paper›PMID 32943016›Full record

ArticleBMC public health2020

Effectiveness of a prevention program in the incidence of cardiovascular outcomes in a low-income population from Colombia: a real-world propensity score-matched cohort study.

Pablo Miranda-Machado, Fernando Salcedo-Mejía, Devian Parra-Padilla, Rusvelt Vargas-Moranth, Nelson Rafael Alvis-Zakzuk, Justo Paz-Wilches, Juan Fernández-Mercado, Fernando De la-Hoz Restrepo, Nelson Alvis-Guzmán

Open access · goldAbstract read
In one paragraph

Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
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  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Pablo Miranda-MachadoALZAK Foundation, Crespo St 67 #5-44, Cartagena, Colombia. mmpa9@hotmail.com.ORCID http://orcid.org/0000-0002-6790-7112
Fernando Salcedo-MejíaALZAK Foundation, Crespo St 67 #5-44, Cartagena, Colombia.
Devian Parra-PadillaALZAK Foundation, Crespo St 67 #5-44, Cartagena, Colombia.
Rusvelt Vargas-MoranthALZAK Foundation, Crespo St 67 #5-44, Cartagena, Colombia.
Nelson Rafael Alvis-ZakzukALZAK Foundation, Crespo St 67 #5-44, Cartagena, Colombia.
Justo Paz-WilchesHealth Risk Management Department, Mutual SER E.P.S, Cartagena, Colombia.
Juan Fernández-MercadoHealth Risk Management Department, Mutual SER E.P.S, Cartagena, Colombia.
Fernando De la-Hoz RestrepoHealth Economics Research Group, University of Cartagena, Cartagena, Colombia.
Nelson Alvis-GuzmánALZAK Foundation, Crespo St 67 #5-44, Cartagena, Colombia.
University of Cartagena · COScience and Technology Corporation for Naval, Maritime and Riverine Industry Development · CO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiovascular diseases (CVDs) and diabetes mellitus (DM) are among the leading cause of morbidity and mortality in low-and-middle-income countries (LMICs) but evidence in these contexts regarding the effectiveness of primary prevention interventions taking into account patient adherence is scarce. We aimed to evaluate the effectiveness of a cardiovascular risk management program (De Todo Corazón - DTC program) in the incidence of the first cardiovascular outcome (CVO) in a low-income population from the Caribbean region of Colombia using adherence as the main variable of exposure.

methodsA retrospective propensity score-matched cohort study was conducted. Adult patients with a diagnosis of hypertension (HTA), diabetes mellitus (DM), chronic kidney disease (CKD), or dyslipidemia affiliated to the DTC program between 2013 and 2018 were considered as the study population. Patients with 30 to 76 years, without a history of CVOs, and with more than 6 months of exposure to the program were included. The main outcome of interest was the reduction in the risk of CVOs (stroke, myocardial infarction, or congestive heart failure) based on the adherence to the intervention (attendance to medical appointments with health care professionals and the control of cardiovascular risk factors). Kaplan Meier curves and propensity score-matched Cox regression models were used to evaluate the association between adherence and the incidence of CVOs.

resultsA total of 52,507 patients were included. After propensity score matching, a sample of 35,574 patients was analyzed. Mean (SD) exposure time was 1.97 (0.92) years. Being adherent to the program was associated to a 85.4, 71.9, 32.4 and 78.9% risk reduction of in the low (HR 0.14; 95% CI 0.05-0.37; p < 0.001), medium (HR 0.28; 95% CI 0.21-0.36; p < 0.001), high-risk with DM (HR 0.67; 95% CI 0.43-1.04; p = 0.075) and hig-risk without DM (HR 0.21; 95% CI 0.09-0.48; p < 0.001) categories, respectively.

conclusionsThe DTC program is effective in the reduction of the risk of CVOs. Population-based interventions may be an important strategy for the prevention of CVOs in underserved populations in the context of LMICs. A more exhaustive emphasis on the control of diabetes mellitus should be considered in these strategies.

Indexed as

Outcome Assessment, Health CarePatient ComplianceRisk Reduction BehaviorAdultAgedCardiovascular DiseasesCohort StudiesColombiaFemaleHumansIncidenceKaplan-Meier EstimateMaleMiddle AgedPovertyPrimary PreventionCardiovascular outcomesCardiovascular risk management programDiabetes mellitusHigh blood pressureUnderserved population

Identifiers

PMID32943016
PMCPMC7500541
OpenAlexW3087192648

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.