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Article: Decline of the chronic respiratory disease mortality in the WHO Western Pacific Region.

Khaltaev, Nikolai / Axelrod, Svetlana

2023 Volume 15, Issue 10, Page(s) 5801–5810

Abstract: Background: Non-communicable diseases (NCDs) are major cause of death all over the world killing 41 million of the 57 million deaths (72%) in 2016. According to World Health Organization (WHO) Director General the biggest decrease in NCD mortality ... ...

Abstract	Background: Non-communicable diseases (NCDs) are major cause of death all over the world killing 41 million of the 57 million deaths (72%) in 2016. According to World Health Organization (WHO) Director General the biggest decrease in NCD mortality between 2000 and 2019 globally were for chronic respiratory diseases (CRDs) a 37% decline. The WHO Western Pacific Region (WPRO) made the biggest gains against CRD a 55.9% drop. We analysed CRD mortality in the WPRO comparing with other WHO regions. Methods: Assessment of the risk factors was made in all WHO countries mainly in 2016. Lifestyle modifications concerning tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol in 2020. We used WHO assessment of ambient and household air pollution attributable to chronic obstructive pulmonary disease (COPD) mortality. Results: WPRO comprises 27 countries, 10 high-income countries (HIC) and 17 middle-income countries (MIC). A total of 52 countries in other WHO regions belong to HIC and 86 countries to MIC. No difference was found in the tobacco demand-reduction measures. Clear difference was demonstrated in the prevalence of the raised blood pressure (RBP) which was lower in the WPRO. In the WPRO HIC every fifth has RBP while in other regions it was every forth. Similar difference was observed for MIC. COPD mortality linked to air pollution was twice higher in the WPRO. It was highest in MIC. CRD management probably plays a crucial role in the decline of the observed mortality in the region since numerous WHO global, regional and national prevention and management CRD approaches and activities have been successfully initiated and implemented there. WHO Global Alliance against Chronic Respiratory Diseases (GARD) was successfully initiated in Beijing in 2006. Two subsequent global GARD meetings held in Seoul [2007] and Beijing [2019] had a tremendous impact on the CRD awareness, prevention and control strategies in the region. These events have stimulated development of the national CRD programmes. Beijing's declaration "Call for action for lung health" stressed the better management of CRD at primary healthcare level. Conclusions: Better RBP control, improved prevention, diagnosis and treatment of CRD could contribute to the observed decline of premature CRD mortality in the region.
Language	English
Publishing date	2023-09-12
Publishing country	China
Document type	Journal Article
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd-22-1466
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Countrywide "best buy" interventions for noncommunicable diseases prevention and control in countries with different level of socioeconomic development.

Khaltaev, Nikolai / Axelrod, Svetlana

Chronic diseases and translational medicine

2022 Volume 9, Issue 1, Page(s) 44–53

Abstract: Background: Noncommunicable diseases (NCDs) place a heavy burden on populations globally and in particular, on lower-income countries (LIC). WHO identified a package of 16 "best buy" lifestyle and management interventions that are cost-effective and ... ...

Abstract	Background: Noncommunicable diseases (NCDs) place a heavy burden on populations globally and in particular, on lower-income countries (LIC). WHO identified a package of 16 "best buy" lifestyle and management interventions that are cost-effective and applicable in all settings. The purpose of this study was to evaluate and compare NCD risk factors in all WHO countries and make preliminary assessment of "best buy" interventions. Methods: Risk factors estimation was made in 188 countries. NCD attributable "best buys" concern tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. Management issues are based on the availability of the national NCD guidelines and provision of drug therapy. Results: Every fourth adult in high-income countries (HIC) has raised blood pressure (RBP). Prevalence of RBP in lower-middle-income countries (LMIC) and LIC is 22%-23% (HIC/LMIC: Conclusion: Wealthier countries have better implementation of the WHO NCD prevention strategy.
Language	English
Publishing date	2022-11-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2831148-6
ISSN	2589-0514 ; 2589-0514
ISSN (online)	2589-0514
ISSN	2589-0514
DOI	10.1002/cdt3.49
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Article ; Online: Countrywide cardiovascular disease prevention and control in 49 countries with different socio-economic status.

Khaltaev, Nikolai / Axelrod, Svetlana

Chronic diseases and translational medicine

2022 Volume 8, Issue 4, Page(s) 296–304

Abstract: Background: Cardiovascular disease (CVD) is the major noncommunicable disease (NCD) accounting for 17.9 million deaths. If current trends continue, the annual number of deaths from CVD will rise to 22.2 million by 2030. The United Nations General ... ...

Abstract	Background: Cardiovascular disease (CVD) is the major noncommunicable disease (NCD) accounting for 17.9 million deaths. If current trends continue, the annual number of deaths from CVD will rise to 22.2 million by 2030. The United Nations General Assembly adopted a sustainable development goal (SDG) by 2030 to reduce NCD mortality by one-third. The purpose of this study was to analyze the CVD mortality trends in different countries implementing World Health Organization (WHO) NCD Action Plan and emphasize effective ways to achieve SDG. Methods: WHO statistics, based on the Member-States unified mortality and causes-of-death reports were used for analyzing trends and different interventions. Results: Reduction of CVD mortality from 2000 to 2016 in 49 countries was achieved for stroke at 43% and ischemic heart disease at 30%. Smoking prevalence and raised blood pressure (RBP) decreased in 84% and 55% of the countries. Eighty-nine percent of high-income countries (HIC) demonstrated a decline in tobacco smoking against 67% in middle-income countries (MIC). Sixty-nine percent of HIC demonstrated a decline in RBP against 15% in MIC. CVD management, tobacco, and unhealthy diet reduction measures are significantly better in HIC. The air pollution level was higher in MIC. Conclusion: Building partnerships between countries could enhance their efforts for CVD prevention and successful achievement of SDG.
Language	English
Publishing date	2022-06-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2831148-6
ISSN	2589-0514 ; 2589-0514
ISSN (online)	2589-0514
ISSN	2589-0514
DOI	10.1002/cdt3.34
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Article: GARD, a new way to battle with chronic respiratory diseases, from disease oriented programmes to global partnership.

Khaltaev, Nikolai

Journal of thoracic disease

2017 Volume 9, Issue 11, Page(s) 4676–4689

Abstract: Initiated by World Health Organization (WHO) Global Chronic Respiratory Disease (CRD)-oriented programmes, Global Initiative on Asthma (GINA), GOLD-Global Initiative for Chronic Obstructive Pulmonary Disease (COPD), Allergic Rhinitis and its Impact on ... ...

Abstract	Initiated by World Health Organization (WHO) Global Chronic Respiratory Disease (CRD)-oriented programmes, Global Initiative on Asthma (GINA), GOLD-Global Initiative for Chronic Obstructive Pulmonary Disease (COPD), Allergic Rhinitis and its Impact on Asthma (ARIA), and Practical Approach to Lung Health (PAL) have catalyzed creation of the Global Alliance Against CRD (GARD). Forty-five countries sharing GARD's goal to reduce the burden of CRD joint GARD. In 20 countries with reliable death estimates, CRD mortality has been analyzed in 2000, 2005, 2010 and 2015. Dramatic decline in CRD mortality is seen in Kyrgyzstan, Netherlands, Italy and Republic of Korea (69%, 55%, 48%, and 48%). Positive trend in COPD mortality is seen for Lithuania (36% decline) and Spain (21%). In France, Japan, Mexico, Romania and Costa Rica, positive trend for asthma mortality is obvious from 2000 to 2015 from about 40% in France and Romania, 50% and Mexico and Czech Republic, 65% in Japan and 69% in Belgium. In Costa Rica zero asthma mortality was registered in 2015. In Czechia and Belgium decline is seen from 2000 to 2005, which then stabilized in Czech Republic and went further down in Belgium. In Finland initially, low asthma mortality remains practically unchanged with slight decline in 2015. In other countries analyzed, we did not see any positive trend in CRD mortality. In all countries with positive CRD dynamic WHO introduced activities remained active, they have been taken into local guidelines and practice and supported national authorities in implementing these evidence-based guidelines. Before GARD launch WHO initiated activities produced a good basis for further GARD movement and by 2010 we see a visible positive trend in CRD mortality in success countries. By 2015 when WHO noncommunicable disease (NCD) Global Action Plan 2013-2020 rollouts globally dramatic decline in total CRD mortality and particularly in Asthma and COPD mortality became obvious. Global disease oriented programmes, national and international partnerships combined with the Global NCD Action Plan most probable produce a positive synergistic effect on the mortality from CRD.
Language	English
Publishing date	2017-12-18
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd.2017.11.91
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Article: Role of Global Alliance against Chronic Respiratory Diseases (GARD) in achievement of the UN sustainable development goals (SDG) and targets.

Khaltaev, Nikolai / Akselrod, Svetlana

Journal of thoracic disease

2021 Volume 13, Issue 8, Page(s) 5117–5122

Language	English
Publishing date	2021-07-12
Publishing country	China
Document type	Editorial
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd-21-857
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Article ; Online: Global trends in diabetes-related mortality with regard to lifestyle modifications, risk factors, and affordable management: A preliminary analysis.

Khaltaev, Nikolai / Axelrod, Svetlana

Chronic diseases and translational medicine

2021 Volume 7, Issue 3, Page(s) 182–189

Abstract: Background: According to the World Health Organization (WHO), a global reduction of 17% has been achieved in the major noncommunicable disease-associated mortality rate since 2000. This decline was due to the decreasing mortality associated with ... ...

Abstract	Background: According to the World Health Organization (WHO), a global reduction of 17% has been achieved in the major noncommunicable disease-associated mortality rate since 2000. This decline was due to the decreasing mortality associated with cardiovascular and chronic respiratory diseases. The WHO has not made any comments on diabetes-related mortality thus far. The objective of this study was to demonstrate trends in diabetes-related mortality associated with country-wide interventions. Methods: The WHO statistics were used to assess trends in diabetes-related mortality from 2000 to 2016. Different types of community-based interventions in 49 countries were compared and assessed. Results: The baseline mortality decreased by 7%. Mortality in middle-income countries was higher than that in high-income countries. The prevalence of obesity showed a gradual increase in all countries. After implementation of the WHO "best buy" in 2010, mortality increased in 17 countries and decreased in 32 countries. Regarding the smoking prevalence trend, 87% countries with decreasing diabetes-related mortality had a gradual decline in tobacco usage since 2000. The decline was observed only in 43% countries with increasing diabetes-related mortality. The prevalence of hypertension increased in 19% countries with declining diabetes-related mortality and in 35% countries with increasing diabetes-related mortality. Physical activity measures tended to be better implemented in countries with declining diabetes-related mortality than in countries with increasing diabetes-related mortality. Conclusion: Smoking cessation and better blood pressure control are associated with declining diabetes-related mortality. Longer implementation periods are needed for other lifestyle interventions.
Language	English
Publishing date	2021-04-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2831148-6
ISSN	2589-0514 ; 2589-0514
ISSN (online)	2589-0514
ISSN	2589-0514
DOI	10.1016/j.cdtm.2021.03.003
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Article: Management of cardiovascular comorbidities in chronic obstructive pulmonary disease patients.

Aisanov, Zaurbek / Khaltaev, Nikolai

Journal of thoracic disease

2020 Volume 12, Issue 5, Page(s) 2791–2802

Abstract: Chronic obstructive pulmonary disease (COPD) is а highly prevalent, complex and heterogeneous clinical condition which is associated with significant concomitant diseases. COPD and cardiovascular diseases (CVDs) often coexist due to the high prevalence ... ...

Abstract	Chronic obstructive pulmonary disease (COPD) is а highly prevalent, complex and heterogeneous clinical condition which is associated with significant concomitant diseases. COPD and cardiovascular diseases (CVDs) often coexist due to the high prevalence of each of these pathological conditions separately as well as the common risk factors (particularly smoking), mechanisms of interaction and influence of systemic inflammation. In addition, decreased pulmonary function in COPD is closely associated with an increased risk of congestive CVDs. One of the most important pathophysiological markers of COPD-lung hyperinflation-plays a significant role in the appearance of functional limitations of the pumping function of the heart, creating unfavorable conditions by exerting a compression effect on the heart muscle. The latter was confirmed by significant correlation between the COPD severity according to GOLD classification and the basic dimensions of the heart chambers. Several decades ago, the term "microcardia" was commonly used and indicated a radiological sign of emphysema. Some studies demonstrated a close relationship between the chance of occurrence of CVD and the severity of pulmonary dysfunction. Such an association has been demonstrated for the whole spectrum of CVD-including cerebrovascular disease, congestive heart failure (CHF) and rhythm disturbances-and was detected in the early stages of the disease. A large proportion of patients with mild and moderate COPD die due to CVD, which is much more likely than deaths in the same group due to respiratory insufficiency. COPD patients have a higher rate of hospitalization and death, the cause of which are coronary heart disease (CHD), stroke and CHF. Treatment of COPD today is mainly determined by national and international clinical guidelines, which should pay more attention to the problems of the treatment of COPD patients with comorbid conditions.
Language	English
Publishing date	2020-07-08
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd.2020.03.60
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Article ; Online: Global lung cancer mortality trends and lifestyle modifications: preliminary analysis.

Khaltaev, Nikolai / Axelrod, Svetlana

Chinese medical journal

2020 Volume 133, Issue 13, Page(s) 1526–1532

Abstract: Background: According to the Independent High-level Commission on Non-communicable Diseases (NCD) of the World Health Organization (WHO), global reduction in lung cancer mortality has been achieved since the year 2000, although this effect is not ... ...

Abstract	Background: According to the Independent High-level Commission on Non-communicable Diseases (NCD) of the World Health Organization (WHO), global reduction in lung cancer mortality has been achieved since the year 2000, although this effect is not sufficient to reach the 30% reduction of mortality from NCDs by the year 2030, as stipulated by the United Nations Sustainable Development Goal 3.4. The objective of this study was to analyze whether the lifestyle changes implemented by the WHO at country level could have an impact on mortality from this form of cancer. Methods: WHO statistics, based on the unified mortality and causes-of-death reports of Member-State countries, were used to evaluate global lung cancer mortality trends and make comparisons and assessments of different types of community-based, country-wide interventions. Results: The lung cancer mortality decline was associated with the anti-tobacco campaign initiated by the WHO in the last 15 to 20 years. Comprehensive tobacco control remained the major and most successful lifestyle modification measure. In countries with declining lung cancer mortality, 91% of countries had decreasing tobacco prevalence in males and 82% in females. Country- wide measures to increase physical activity had a strong tendency to be better implemented in countries with declining lung cancer mortality (t = 1.79, P > 0.05). Other WHO "best-buy" lifestyle modification campaigns (diet and alcohol) had been carried out for shorter periods, and their associations with lung cancer were less strong than tobacco. There was no significant difference between countries with declining and increasing lung cancer mortality in the measures for reduction of harmful alcohol use (t = 0.92, P > 0.05) and unhealthy diet reduction measures (t = 0.84, P > 0.05). Conclusion: Following WHO "best-buys" should facilitate to move countries towards the NCD including lung cancer mortality reduction targets. Governments and communities must embrace these targets with coordinated effective action for better health.
MeSH term(s)	Female ; Humans ; Life Style ; Lung Neoplasms ; Male ; Noncommunicable Diseases ; World Health Organization
Language	English
Publishing date	2020-07-13
Publishing country	China
Document type	Journal Article
ZDB-ID	127089-8
ISSN	2542-5641 ; 0366-6999 ; 1002-0187
ISSN (online)	2542-5641
ISSN	0366-6999 ; 1002-0187
DOI	10.1097/CM9.0000000000000918
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Article: Chronic respiratory diseases global mortality trends, treatment guidelines, life style modifications, and air pollution: preliminary analysis.

Khaltaev, Nikolai / Axelrod, Svetlana

Journal of thoracic disease

2019 Volume 11, Issue 6, Page(s) 2643–2655

Language	English
Publishing date	2019-07-31
Publishing country	China
Document type	Editorial
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd.2019.06.08
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Article: Balneotherapy and hydrotherapy in chronic respiratory disease.

Khaltaev, Nikolai / Solimene, Umberto / Vitale, Federico / Zanasi, Alessandro

Journal of thoracic disease

2020 Volume 12, Issue 8, Page(s) 4459–4468

Abstract: Chronic respiratory diseases (CRD) belong to major noncommunicable diseases (NCD) targeted by World Health Organization (WHO) NCD Action Plan and United Nations (UN) Sustainable Development Goal (STG) 3.4 to achieve 30% decline of mortality by the year ... ...

Abstract	Chronic respiratory diseases (CRD) belong to major noncommunicable diseases (NCD) targeted by World Health Organization (WHO) NCD Action Plan and United Nations (UN) Sustainable Development Goal (STG) 3.4 to achieve 30% decline of mortality by the year 2030. Strong evidence is now available in the literature for therapeutic aquatic exercise interventions in improving health status of chronic obstructive pulmonary diseases (COPD) patients. However, gym-based exercises can be difficult for patients with COPD who are mainly elderly and often have co-morbidities-such as severe arthritis and obesity-which may impair their ability to exercise at an adequate intensity. Besides improving respiratory function and health status in COPD, exercise in water helps overcoming patient's fears and promote socialization, contrasting the risk of depression, which is a major condition often associated with long term COPD condition. Susceptibility to respiratory infections plays a role in exacerbations of COPD. Sulphur-rich water inhalations improve muco-ciliary clearance, reduce inflammatory cytokines production and inflammatory mucosal infiltration, reduce elastase secretion by neutrophils, preserving elastic properties of pulmonary interstitium and thus facilitating expectoration. Repeated cold water stimulations in COPD also reduce frequency of infections. Finally, sauna bathing reduces the risk of pneumonia. On the other side, hydrotherapy/balneotherapy also help obesity control, which is one of the most difficult NCD risk factors to modify and consequently is an important component of the WHO preventive strategy to achieve STG 3.4. Along with high prevalence and mortality, CRD cause increasing pharmaceutical and hospital costs. In this perspective, Health Resort Medicine should not be ignored as a resource in the WHO NCD strategy and Universal Health Coverage, providing a multi-stakeholder platform (including the network of health resorts and their facilities) able to give a real help to the achievement of UN goal STG 3.4 by the year 2030.
Language	English
Publishing date	2020-09-09
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd-gard-2019-009
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