Epidemiology of cardiovascular risk factors and the medical care appealability

A. S. Agienko, I. L. Strokolskaya, V. Y. Heraskov, G. V. Artamonova
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引用次数: 1

Abstract

Highlights. Unique epidemiological data were obtained on the effectiveness of preventive services of healthcare organizations in relation to cardiovascular diseases, adherence to lifestyle modification recommendations, and presence of risk factors for cardiovascular diseases in these citizens.Aim. To assess healthcare services uptake in large industrial Siberian region, as well as the adherence of population to lifestyle modification recommendations (epidemiological data).Methods. The study included 729 residents of Kemerovo and Kemerovo region. The assessment of the main risk factors for cardiovascular diseases was carried out in accordance with the Russian recommendations for cardiovascular prevention. Uptake and adherence to lifestyle modification recommendations was assessed using the Health System Assessment Questionnaire of the International Prospective Study of Urban and Rural Epidemiology.Results. Among the 729 study participants, the urban population is represented by 67.3%, rural – 32.6%. The population was majority represented by women (69.7%). The mean age of participants was 59.0 (51.0; 65.0) years. Smokers accounted for 18.6% of the participants, the majority represented by men (p = 0.000). Excessive weight was more often observed in women (p = 0.013), the mean body mass index in women was 29.5 kg/m2 . The mean values of the analyzed laboratory parameters (cholesterol, low- and highdensity lipoprotein cholesterol, triglycerides, glucose) were within the range of normal values. Previously diagnosed hypertension was noted in 64.6% of the participants, diabetes in 12%, coronary heart disease in about 7%, stroke in 1.6% of the participants. Assessment of cardiovascular risk according to SCORE scale showed that 17% of participants were at low risk, 50% – moderate risk in, and 29.2% – high-very high risk. Upon visiting healthcare provider, only 38.1% of subjects received recommendations for lifestyle changes. Respondents were frequently given recommendations to adjust their diet, followed by recommendations regarding weight loss, increased physical activity; smoking cessation and lower alcohol consumption were recommended less often. Respondents changed their lifestyle significantly more often in accordance with the recommendations received at the time of visit (p = 0.000); out of them, 56.7% had moderate cardiovascular risk, 26.7% had high and very high risk, and low risk according to SCORE – 16.7%. However, study participants were more likely to not follow received recommendations (p = 0.000).Conclusion. Due to high uptake of healthcare services in the population, high prevalence of risk factors and low adherence of the population to prevention, it can be concluded that the current model of prevention does not work. Innovative tools are needed to manage risk factors for cardiovascular diseases and positively change a person`s lifestyle.
心血管危险因素的流行病学及医疗申诉
高光。在心血管疾病、生活方式改变建议的依从性以及这些公民心血管疾病风险因素方面,获得了保健机构预防服务有效性的独特流行病学数据。评估西伯利亚大工业地区医疗保健服务的接受情况,以及人口对生活方式改变建议的依从性(流行病学数据)。该研究包括克麦罗沃和克麦罗沃地区的729名居民。根据俄罗斯关于预防心血管疾病的建议,对心血管疾病的主要危险因素进行了评估。采用国际城乡流行病学前瞻性研究的卫生系统评估问卷对生活方式改变建议的接受和遵守情况进行了评估。在729名研究参与者中,城市人口占67.3%,农村人口占32.6%。人口中以妇女占多数(69.7%)。参与者平均年龄为59.0岁(51.0岁;65.0)年。吸烟者占参与者的18.6%,其中大多数为男性(p = 0.000)。女性体重超标较多(p = 0.013),女性平均体重指数为29.5 kg/m2。所分析的实验室参数(胆固醇、低、高密度脂蛋白胆固醇、甘油三酯、葡萄糖)的平均值均在正常值范围内。先前诊断为高血压的参与者占64.6%,糖尿病占12%,冠心病约占7%,中风占1.6%。根据SCORE量表进行的心血管风险评估显示,17%的参与者处于低风险,50%的参与者处于中度风险,29.2%的参与者处于高-非常高风险。在访问医疗保健提供者时,只有38.1%的受试者接受了生活方式改变的建议。调查对象经常得到调整饮食的建议,随后是关于减肥、增加体育活动的建议;戒烟和减少饮酒的建议较少。根据就诊时收到的建议,受访者改变生活方式的频率显著提高(p = 0.000);其中56.7%为中度心血管危险,26.7%为高危和极高危,低危(SCORE - 16.7%)。然而,研究参与者更有可能不遵循收到的建议(p = 0.000)。由于人口对保健服务的接受程度高,危险因素的流行率高,人口对预防的依从性低,因此可以得出结论,目前的预防模式不起作用。需要创新的工具来管理心血管疾病的风险因素,并积极改变一个人的生活方式。
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