Determinants of heart disease

Introduction

Determinants of heart disease

Cardiovascular conditions have been associated with high mortality than any other condition. However, it is essential to understand the underlying factors that increase the likelihood of an individual having a heart disease. There are different aspects that are involved in the development of cardiovascular diseases. The determinants of cardiovascular risk factors are having a significant influence on societal progress and the major interventions that are identified. The major determinants are grouped into different categories which include physical, social, psychological, healthcare system, behavioural and environmental factors.

The variables in the study

The variables that form the of the analysis will include dependent variable and independent variables. The independent variables that have been included in the analysis include age, sex, chest pain, resting blood pressure, serum cholesterol, resting electrocardiographic results, maximum heart rate achieved, exercise-induced angina old peak, slope number of major vessels and thallium stress. The dependent variable is the presence of heart disease, which is categorical.

Logistic regression test

The research, therefore, focused on determining factors that predict heart disease from the selected variables that were assessed. Binary logistic regression is the appropriate logistic regression method considering that the dependent variable has two subgroups where it is either an individual has heart disease or not.

Analysis results

The total sample population was 302. The classification table shows that 150 of the respondents were correctly identified as having heart disease. The results also show that 106 respondents were correctly identified as not having a heart disease. Fourteen of the patients were observed as having heart disease, although the prediction showed negative results. Similarly, 32 of the respondents were negative, but they were found as being positive. The accuracy of the independent variables in predicting heart disease correctly was 91.5% while the specificity was 76.8%.

From the table, it is observed that at 95% confidence level,  sex ( p =0.0002), Chest pain (p = 4.14E-06), maximum heart rate achieved ( p = 0.027), exercise-induced angina (p = 0.02), old peak ( p = 0.011), number of major vessels ( p = 5.85E-05) and thallium stress test ( p = 0.0025) were statistically significant predictors of heart disease presence. Thus the findings show that female respondents had a reduced chance of having heart disease (OR = 0.17). Increases in chest among respondents was 2.34 times likely to lead to heart disease. An increase in maximum heart rate achieved resulted in 1.023 times the likelihood of developing heart disease. An increase in exercise-induced angina was associated with a reduced risk of developing heart disease (OR= 0.38). Increase in the old peak was also associated with a reduced chance of heart disease (OR= 0.58). Increase in a number of major vessels and increase in thallium stress test were associated with reduced development of heart disease.

Discussion of the findings

The results obtained in this case are not standalone; there is numerous past literature that obtained similar findings which emphasizing on different factors that are likely to predict heart disease. Human and biological factors have had a major influence on individual health development. According to Eslami et al. (2014), gender, genetic age, race and ethnicity are essentially human and biological determinants that are associated with the development of heart disease. The burden for heart disease varies across different groups. Sabzmakan et al. (2014) identified that African Americans and individuals with families with a history of cardiovascular disease are highly affected with a three-time likelihood of development of the cardiovascular disease than other groups. Yusuf et al. (2004) in a cross-sectional study conducted, showed that increasing age, family history, male gender and increasing age were associated with the presence of heart disease. In addition, Scheuner et al. (2010) also found that older men were more likely to have cardiovascular disease.

Individual behaviour and lifestyle have also been associated with the development of cardiovascular conditions. Barolia et al. (2013) identified that diet, physical activities, individual alcohol consumption and cigarette smoking were identified as significant risk factors predicting the presence of heart disease among individuals. In addition, Garnweidner (2013) identified that countries with high cholesterol consumption in the diet, with many smokers, obese and high level of alcohol consumption have a high number of cardiovascular disease cases. Improving quality of life is dependent on positive behavioural patterns which emphasize nutritious feeding programs as well as physical activities.

Psychological wellbeing of individuals has a greater influence on health outcomes. Tindle et al. (2010) identified that stress, depression, anger and anxiety increases individual chances of developing cardiovascular conditions. However, different individuals have different personalities and the ability to manage stressful events in their lives. Davis et al. (2014) highlight that individual needs and ideologies vary, which is a key approach in presenting better strategies for change.

Socio-economic factors play a key role in presenting a strong system that helps maintain important processes within an economic context. Sabzmakan et al. (2014) found that social support is instrumental in improving the health status of individuals suffering from heart conditions. High level of mortality from cardiovascular conditions has been in low-income earners as well as low education attainment (Prabhakaran, Jeemon & Roy, 2016). The research, in this case, is focusing on determining determinants of heart disease, taking into consideration, biological, behavioural, human, social and psychological factors.