Determinants of Ischemic heart disease in Jimma University Medical Center, South West Ethiopia

Abstract

Background: Ischemic heart disease (IHD) is a condition in which there is inadequate supply of blood and oxygen to a portion of the myocardium. IHD causes more deaths and disability and incurs greater economic costs than any other illnesses in the developed world. In the worldwide INTERHEART study, nine potentially modifiable factors accounted for over 90% of the population-attributable risk of a first MI. At least two-thirds of CVDs now occur in low and middle income countries, bringing a double burden of disease to poor and developing world economies. Objective: To assess determinants of ischemic heart disease in JUMC, South West Ethiopia, 2017 Method: Hospital based age matched case control study was applied and data were collected by interview based structured questionnaire, anthropometric measurements and laboratory analysis of blood which were undertaken from May 13 to July 21, 2017. All cases of IHD within the study period were included until the sample sizes were achieved in both cases and controls. Descriptive, bivariate and multivariate backward conditional logistic regression was performed & variables with p-value <0.05 were taken as statistically significant determinants for IHD using case to control ratio of 1:2 and OR with its 95% CI. Result: A total of 64 (33.33%) cases and 128(66.67%) controls were included in the study. Educational status (can’t read and write), history of hypertension and family history of cardiac disease were a significant determinants of IHD with adjusted odds ratio of (AOR=2.59, 95%CI; 1.20-5.61), (AOR=3.02, 95%CI; 1.47-6.19) & (AOR=2.39, 95%CI; 1.06-5.40), respectively. Use of alcohol increases the chance of IHD by 2.79 (AOR = 2.79, 95% CI; 1.47-5.27) and use of khat by 2.58 (AOR= 2.58, 95% CI; 1.36-4.89). And similarly those who consume fruit <4 days/week were two times (AOR=2.11 95% CI; 1.07-4.17) more likely to develop IHD. Use of solidified oil was four times (AOR=4.08, 95% CI; 1.49-11.20) more likely to develop IHD than use of liquid vegetable oil. Dyslipidemia was also the most significant risk factor with adjusted odds ratio of hypercholesterolemia (AOR=2.67, 95% CI; 1.32-5.42) and hypertriglyceridemia (AOR=2.83, 95% CI; 1.42-5.65). Conclusion and recommendation: this study showed that modifiable and preventable various behavioral, dietary and metabolic risk factors were important etiology behind the occurrence of IHD. Though, hypertriglyceridemia was in debate as a cause of IHD, this study found a significant association. So, lipid profile measurement should be part of a treatment plan for IHD. Besides, further prospective studies are suggested including recently emerging novel risk factors.