Primary Prevention of Cardiovascular Risk in Lithuania—Results from EUROASPIRE V Survey
Abstract
:1. Introduction
2. Materials and Methods
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- Very high CVD risk: patients with any of the following: a) diabetes with target organ damage or at least three major risk factors or early onset of type 1 diabetes of a duration of >20 years, b) severe chronic kidney disease (estimated glomerular filtration rate of <30 mL/min/1.73 m2), c) a calculated Systematic Coronary Risk Estimation (SCORE) ≥10% for a 10-year risk of fatal CVD or d) familial hypercholesterolemia with atherosclerotic CVD or with another major risk factor.
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- High CVD risk: patients with markedly elevated single risk factors, familial hypercholesterolemia without other major risk factors, diabetes without target organ damage, with a diabetes duration ≥10 years or another additional risk factor, moderate chronic kidney disease (estimated glomerular filtration rate of 30–59 mL/min/1.73 m2) and a calculated SCORE ≥5% and <10%.
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- Moderate CVD risk: young patients (type 1 diabetes <35 years or type 2 diabetes <50 years) with a diabetes duration <10 years without other risk factors and a calculated SCORE ≥1% and <5%.
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- Low CVD risk: a calculated SCORE <1%.
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- Do you think everyone needs to know their risk of having heart disease, stroke or another vascular disease to reduce the risk? The possible responses were “strongly disagree”, “disagree”, “neither agree nor disagree”, “agree” or “strongly agree”.
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- Are you worried that you may have heart disease, stroke or another vascular disease? The possible responses were “strongly disagree”, “disagree”, “neither agree nor disagree”, “agree” or “strongly agree”.
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- Are you afraid to find out what is your risk of having heart disease, stroke or another vascular disease? The possible responses were “strongly disagree”, “disagree”, “neither agree nor disagree”, “agree” or “strongly agree”.
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- What is your risk of developing heart disease, stroke or another vascular disease in the next 10 years? The possible responses were “very low”, “low”, “moderate”, “high”, “very high” or “do not know”.
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- Do you think your risk of developing heart disease, stroke or another vascular disease in the next 10 years is higher, lower or the same as that of other people of your gender and age? The possible responses were “much higher”, “higher”, “same”, “lower” or “much lower”.
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- LDL-C: <1.4 mmol/L for individuals at very high CVD risk, <1.8 mmol/L for individuals at high risk, <2.6 mmol/L for individuals at moderate risk and <3.0 mmol/L for individuals at low risk (targets recommended by the 2019 ESC/EAS dyslipidemia management guidelines [21]);
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- triglycerides: <1.7 mmol/L (a target recommended by 2019 ESC/EAS dyslipidemia management guidelines [21]);
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- body weight: body mass index (BMI), 20–25 kg/m2, waist circumference <94 cm (men) and <80 cm (women) (targets recommended by 2016 JES guidelines on CVD prevention [6]);
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3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | |
---|---|
Sociodemographic characteristics | |
Gender, n (%) | |
women | 128 (63.7) |
men | 73 (36.3) |
Age, median (Q1, Q3 *), years | 59.0 (50.0–65.0) |
Age groups, n (%) | |
<45 years | 22 (10.9) |
45–54 years | 46 (22.9) |
55–64 years | 77 (38.3) |
≥65 years | 56 (27.9) |
Education, n (%) | |
basic | 9 (4.5) |
secondary | 38 (18.9) |
high (university or college) | 154 (76.6) |
Employment, n (%) | |
employed | 132 (65.7) |
partially employed | 11 (5.5) |
unemployed | 58 (28.9) |
retired | 57 (28.4) |
Self-reported income level, n (%) | |
very low | 6 (3.0) |
low | 43 (21.4) |
moderate | 149 (74.1) |
high | 3 (1.5) |
Vital signs | |
Systolic blood pressure, median (Q1, Q3), mmHg | 136.0 (128.0–146.3) |
Diastolic blood pressure, median (Q1, Q3), mmHg | 88.0 (81.8–94.0) |
Heart rate, median (Q1, Q3), beats/min | 73.0 (67.0–81.0) |
Laboratory parameters | |
Total cholesterol, median (Q1, Q3), mmol/L | 5.8 (5.0–6.8) |
Low-density lipoprotein cholesterol, median (Q1, Q3), mmol/L | 3.8 (3.1–4.5) |
High-density lipoprotein cholesterol, median (Q1, Q3), mmol/L | 1.3 (1.1–1.7) |
Triglycerides, median (Q1, Q3), mmol/L | 1.4 (0.9–2.0) |
Total cardiovascular risk | |
Low risk | 16 (8.0) |
Moderate risk | 64 (31.8) |
High risk | 75 (37.3) |
Very high risk | 46 (22.9) |
Medical history | |
Metabolic syndrome, n (%) | 130 (64.7) |
Diabetes, n (%) | 55 (27.4) |
Impaired glucose tolerance **, n (%) | 18 (9.0) |
Impaired fasting glycemia ***, n (%) | 23 (11.4) |
SCORE †, median (Q1, Q3) | 2.0 (1.0–4.5) |
All Patients N = 201 | Cardiovascular Risk Group | Metabolic Syndrome | |||||
---|---|---|---|---|---|---|---|
Low Risk N = 16 | Moderate Risk N = 64 | High Risk N = 75 | Very High Risk N = 46 | Yes N = 130 | No N = 71 | ||
Low-density lipoprotein cholesterol target * | 9 (4.5) | 3 (18.8) | 4 (6.2) | 1 (1.3) | 1 (2.2) † | not applicable | not applicable |
Triglycerides <1.7 mmol/L ** | 126 (62.7) | 14 (87.5) | 42 (65.6) | 45 (60.0) | 25 (54.3) | 60 (46.2) † | 66 (93.0) |
Statins use, n (%) | 42 (20.9) | 2 (4.8) | 5 (11.9) | 22 (52.4) | 13 (31.0) † | 32 (76.2) † | 10 (14.1) |
Waist circumference <94 cm (men) and <80 cm (women) ** | 35 (17.4) | 5 (31.2) | 13 (20.3) | 14 (18.7) | 3 (6.5) | 5 (3.8) † | 30 (42.3) |
Body mass index 20–25 kg/m2 ** | 31 (15.4) | 7 (43.8) | 5 (7.8) | 16 (21.3) | 3 (6.5) † | 7 (5.4) † | 24 (33.8) |
Blood pressure <140/90 mmHg ** | 115 (57.2) | 8 (50.0) | 34 (53.1) | 48 (64.0) | 25 (54.3) | 73 (56.2) | 42 (59.2) |
Blood pressure <130/80 mmHg *** | 39 (19.4) | 4 (25.0) | 11 (17.2) | 15 (20.0) | 9 (19.6) | 18 (13.8) † | 21 (29.6) |
Questions on Cardiovascular Risk Perception | All Patients N = 201 |
---|---|
Do you think everyone needs to know their risk of having heart disease, stroke or another vascular disease to reduce the risk? | |
Agree or strongly agree | 180 (89.6) |
Are you worried that you may have heart disease, stroke or another vascular disease? | |
Agree or strongly agree | 153 (76.1) |
Are you afraid to find out what is your risk of having heart disease, stroke or another vascular disease? | |
Agree or strongly agree | 69 (34.3) |
What is your risk of developing heart disease, stroke or another vascular disease in the next 10 years? * | |
Very low or low | 16 (8.0) |
Moderate | 90 (44.8) |
High | 52 (25.9) |
Very high | 16 (8.0) |
Do not know | 26 (12.9) |
Do you think your risk of developing heart disease, stroke or another vascular disease in the next 10 years is higher, lower or the same as that of other people of your gender and age? * | |
Higher or much higher | 93 (46.3) |
Same | 81 (40.3) |
Much lower or lower | 26 (12.9) |
What Is Your Risk of Developing Heart Disease, Stroke or Another Vascular Disease in the Next 10 Years? | Cardiovascular Risk Group | Metabolic Syndrome | ||||
---|---|---|---|---|---|---|
Low Risk N = 16 | Moderate Risk N = 64 | High Risk N = 75 | Very High Risk N = 46 | Yes N = 130 | No N = 71 | |
Very low or low | 0 | 9 (14.1) | 3 (4.1) | 4 (8.7) | 8 (6.2) | 8 (11.3) |
Moderate | 7 (43.8) | 24 (37.5) | 40 (54.1) | 19 (41.3) | 60 (46.5) | 30 (42.3) |
High | 7 (43.8) | 17 (26.6) | 20 (27.0) | 8 (17.4) | 34 (26.4) | 18 (25.4) |
Very high | 0 | 2 (3.1) | 4 (5.4) | 10 (21.7) | 14 (10.9) | 2 (2.8) |
Do not know | 2 (12.5) | 12 (18.8) | 7 (9.5) | 5 (10.9) | 13 (10.1) | 13 (18.3) |
Actions to Reduce Cardiovascular Risk | All Patients N = 201 | Cardiovascular Risk Group | Metabolic Syndrome | ||||
---|---|---|---|---|---|---|---|
Low Risk N = 16 | Moderate Risk N = 64 | High Risk N = 75 | Very High Risk N = 46 | Yes N = 130 | No N = 71 | ||
Reduced salt intake | 141 (70.1) | 13 (81.2) | 39 (60.9) | 50 (66.7) | 39 (84.8) | 98 (75.4) | 43 (60.6) |
Reduced sugar intake | 160 (79.6) | 11 (68.8) | 50 (78.1) | 59 (78.7) | 40 (87.0) | 51 (71.8) | 109 (83.8) |
Reduced alcohol intake | 124 (61.7) | 10 (62.5) | 42 (65.6) | 42 (56.0) | 30 (65.2) | 39 (54.9) | 85 (65.4) |
No current smoking | 144 (71.6) | 10 (62.5) | 33 (51.6) | 52 (69.3) | 17 (37.0) * | 75 (57.7) | 37 (52.1) |
Weight reduction efforts | 67 (33.3) | 7 (43.8) | 21 (32.8) | 25 (33.3) | 14 (30.4) | 77 (59.2) * | 57 (80.3) |
Regular physical activity | 55 (27.4) | 6 (37.5) | 19 (29.7) | 19 (25.3) | 11 (23.9) | 31 (23.8) | 24 (33.8) |
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Urbonas, G.; Vencevičienė, L.; Valius, L.; Krivickienė, I.; Petrauskas, L.; Lazarenkienė, G.; Karpavičienė, J.; Briedė, G.; Žučenkienė, E.; Vencevičius, K. Primary Prevention of Cardiovascular Risk in Lithuania—Results from EUROASPIRE V Survey. Medicina 2020, 56, 134. https://doi.org/10.3390/medicina56030134
Urbonas G, Vencevičienė L, Valius L, Krivickienė I, Petrauskas L, Lazarenkienė G, Karpavičienė J, Briedė G, Žučenkienė E, Vencevičius K. Primary Prevention of Cardiovascular Risk in Lithuania—Results from EUROASPIRE V Survey. Medicina. 2020; 56(3):134. https://doi.org/10.3390/medicina56030134
Chicago/Turabian StyleUrbonas, Gediminas, Lina Vencevičienė, Leonas Valius, Ieva Krivickienė, Linas Petrauskas, Gintarė Lazarenkienė, Justina Karpavičienė, Gabrielė Briedė, Emilė Žučenkienė, and Karolis Vencevičius. 2020. "Primary Prevention of Cardiovascular Risk in Lithuania—Results from EUROASPIRE V Survey" Medicina 56, no. 3: 134. https://doi.org/10.3390/medicina56030134