Cardiovascular disease risk in Turkish family health centers

Impaired perception of cardiovascular risk and health literacy in individuals with high cardiovascular diseases risk from different socioeconomic levels in Antalya, Turkey

BACKGROUND

This study aimed to determine how the frequency of impaired perception of cardiovascular disease (CVD) risk is correlated with health literacy in individuals with high CVD risk in two regions with different socioeconomic levels.

METHODS

A descriptive study was conducted. The Systematic Coronary Risk Estimation, recommended by the European and Turkish Cardiology Societies, provides recommendations based on individuals' actual CVD risk levels. According to the Systematic Coronary Risk Estimation, participants suffering from diseases were identified as high and very high risk. The perception of risk was determined by subjectively assessing the risk level of the individuals. The European Health Literacy Survey Questionnaire was used. The Mann-Whitney U test, Chi-squared test and Spearman's correlation analysis were used to analyse the data. We also conducted a logistic regression analysis to identify factors contributing to impaired perception of CVD risk.

RESULTS

A total of 384 individuals, aged between 40 and 70years (with a mean age of 58.35±8.33years), were included in the study. These individuals had a high risk of CVD and were registered to family health centres from two different socioeconomic levels. Out of the 384 participants, 201 individuals belonged to the lower socioeconomic level region and 183 individuals belonged to the higher socioeconomic level region. A total of 61.7% of the participants with high CVD risk had an impaired perception of CVD risk. The health literacy level of 59.9% of individuals was either inadequate or problematic. The health literacy score of participants with impaired risk perception (29.59±9.07) was lower than those with correct risk perception (35.83±10.94; P <0.001). Factors that affected the perception of CVD risk included age, education level, working status, occupation, a family history of CVD, the CVD risk assessment by health professionals and the recommendation of health professionals to individuals for CVD screening.

CONCLUSIONS

It is necessary for health care professionals to make risk assessments and perform interventions to improve health literacy to raise the awareness of individuals with high CVD risk on their actual risk.

40-65 Yaş Erkeklerin Gerçek ve Algıladıkları Kardiyovasküler Hastalık Risklerinin Karşılaştırılması: Bir Kesitsel Çalışma

Objective: To determine the actual cardiovascular diseases risk and to compare it with the perceived risk in 40-65 years old men. Methods: We conducted a cross-sectional study in a population determined to be 21.039 men and sample consisted of 400 men. The actual cardiovascular diseases risks of these respondents were calculated using HeartScore, classified as low, moderate, high, or very high. The respondents’ perception of their cardiovascular disease’s risks was categorized as wrong optimists/pessimists and realists. We used multivariate logistic regression models to determine the relationships between perceived cardiovascular diseases risk and independent variables (age, diabetes, hypertension, etc.). Required ethics committee and institutional permissions were obtained for the duly conduct of the study. Results: It was determined in our study that while 8.3% (n=33) of the men had a high-risk level for cardiovascular disease, 52.5% (n=210) had a very high level. Forty-eight percent of the participants perceive their CVD risks to be lower than they are and 23.8% to perceive it higher than they are. Correct estimation rate of CVD risk was 28.2%. The variables affecting the actual cardiovascular diseases risk were diastolic blood pressure, body mass index, and level of physical activity. 13.3% (n=53) of respondents perceived their cardiovascular diseases risks as high and 8% (n=32) as very high. The variables affecting an incorrect perceived cardiovascular diseases risk are being 61-65 years of age (odds ratio=0.34, 95% confidence interval: 0.16-0.73) and a diagnosis of diabetes mellitus (odds ratio=0.45, 95% confidence interval: 0.20-0.99). Conclusion: We observed that more than half of the residents were at a very high level of risk for cardiovascular disease, and approximately one out of every two respondents perceived their risk of cardiovascular disease to be lower than the actual risk. It is recommended risk reducing behaviors be developed and awareness of risk be raised.

Effectiveness of a nurse-led physical activity intervention to decrease cardiovascular disease risk in middle-aged adults: A pilot randomized controlled study

The purpose of this study was to evaluate the effectiveness of the nurse-led physical activity (PA) intervention on cardiovascular disease (CVD) risk reduction in individuals with moderate risk. A randomized controlled pilot trial was conducted with 12 individuals who have moderate cardiovascular risk meeting the inclusion criteria. Eleven individuals in the intervention group participated in a 12-week PA program (outdoor group walking with the group 5 days in a week, each lasting for 40 minutes) guided by a nurse. For determining the risk level of CVD, the "HeartScore program" was used. Height, weight, blood pressure, and cholesterol values of individuals in the intervention group were measured. At the end of nurse-led outdoor walking activity with the group for 12 weeks, systolic blood pressure (P = .041) and cholesterol (P = .001) values of individuals in the intervention group decreased based on the baseline levels and accordingly CVD risk levels decreased significantly (P = .019). There was no significant difference in the control group. This study demonstrates that health care professionals working in the family health centers can easily determine the CVD risk with the HeartScore. Outdoor group walking program guided by a nurse is effective in decreasing the CVD risk level.

Age-Dependent Disparities in the Prevalence of Single and Clustering Cardiovascular Risk Factors: A Cross-Sectional Cohort Study in Middle-Aged and Older Adults

Background

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide; with age acknowledged as an independent cardiovascular risk factor (CRF) in adults. Appreciating the association between age and classic CRFs is believed to boost all potential benefits of prevention.

Purpose

Assessment of the prevalence of single and clustered CRFs and their association with age.

Patients and Methods

The survey involved 4735 people (33.6% men) who were PONS project attendees aged 45-64. The study protocol comprised the Health Status Questionnaire, general medical examination, anthropometric measurements, and blood and urine sampling. The prevalence of single and clustered CRFs (hypertension, dyslipidemia, diabetes mellitus, and obesity) in the incrementally split age groups was calculated. The incidence rate of CRFs, against their absence, was determined by Poisson regression models with robust standard errors.

Results

The prevalence of CRFs was established in 90% of the respondents. Except dyslipidemia and ≥1 CRFs, prevalence of risk factors increased with age, although this trend was the weakest in men. In the total group, and in women, prevalence of dyslipidemia and ≥1 CRFs was unrelated to age, whereas in men, it was on the rise in the younger age groups. The incidence rate of CRFs was strongly related to age, and, with the exception of dyslipidemia, was higher in the older age groups.

Conclusion

Cardiovascular risk factors are common in the adult population, while their prevalence and clustering are more prevalent in seniors. Apart from dyslipidemia, the risk of CRFs is appreciably age-related, and higher in seniors.