CLINICAL PRESENTATION OF CARDIOVASCULAR DISEASES AMONG YOUNG ADULTS IN PESHAWAR, PAKISTAN: A MULTICENTERE CROSS-SECTIONAL STUDY
Keywords:
Cardiovascular Diseases, Hypertension, Diabetes, Cardiovascular Risk Factors, Clinical Outcomes, cross-sectional studyAbstract
Background. Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality, and their burden continues to rise among young adults globally. Major risk factors, including hypertension, diabetes, smoking, and physical inactivity, are driving the age of CVDs onset to shift earlier. However, data on the clinical presentation and risk characteristics of CVDs in this population remain limited, especially in resource-limited regions. This study, therefore, describes the clinical presentation of CVDs among young adults. Methods. This study was conducted in Peshawar, Pakistan, as a multi-center retrospective cross-sectional study in four public sector tertiary hospitals. Data was extracted from the Hospital Management Information System, using a census sampling technique in accordance with pre-set inclusion criteria, and the analysis was conducted using advanced statistical tests. Results. A total of 8,650 records were screened, and 2,090 met the eligibility criteria of young adults and Pakistani nationality. Participants were predominantly male (65%) with a median age of 38 years (IQR 34–42). Hypertension was the most common risk factor (50.5%), followed by diabetes mellitus (38.7%). In young age the 70% of patients were severe Killip classes (III–IV) and the unstable angina was (58.5%). Multivessel coronary artery disease (55%) and high lesion complexity (40% Type C) were frequent. Mean blood pressure was elevated (139.2/82.3 mmHg) and the median hospital stay was 6 days (IQR 4–8). Diabetes mellitus (IRR 1.20; 95% CI 1.09–1.32), hypertension (IRR 1.15; 95% CI 1.05–1.26), and elevated heart rate (IRR 1.08; 95% CI 1.03–1.13) were all associated with extended hospitalisation in a multivariable negative binomial regression. Adherence to protocol-recommended therapy at discharge was over 94%. Conclusion. CVDs were associated with modifiable risk factors, and they were often associated with severe clinical and anatomic features. Early detection and treatment may help reduce the disease burden and improve outcomes. Prevention, awareness raising, and early screening are likely needed to curb the growing burden of CVDs in this population.
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