Risk factors and disease prevalence in 3331 personal check-ups performed in preventive medicine between 2006 and 2011. cross-sectional and follow-up study.

Abstract

Introduction: The present data results from a retrospective analysis of 3331 check-ups made in the preventive medicine department of the "ZithaKlinik", named "ZithaGesondheetsZentrum". These check-ups are done for the employee's of several firm's and institutions. According to gender and age, several tests and examinations are performed and the results are given to the person's general practitioner or another doctor of his choice. We will present a global synthesis of all the results but also a follow-up study of persons having performed 2 check-ups or more over a 5-year period.

Population: In the cross-sectional part, the analysis is done on 3331 individual check-ups (1447 woman, 1884 men). The average age is 50.3 years +/- 11.4. In the follow-up study, 478 persons (191 women, 287 men) had at least 2 (maximum 5) check-ups in the 5-year period of our observation. Initial age was 54.1 +/- 10.9 years for woman and 51.4 +/- 11.4 for men, respectively 56.4 +/- 10.9 and 53.7+/- 11.2 at their last check-up.

Results: An alarming number of persons present with a weight or obesity problem (according to age ranging from 22.0% overweight and 7.3% obese from 18-29 years, respectively 37.5% and 11.3% from 30-49 years, finally 44.0% and 20.6% in the range 50-69 years). Associated risk factors and pathologies (Hypertension, Dyslipidemia, NASH, diabetes type 2 and complete metabolic syndromes) are extremely frequent and getting more so with growing age. Furthermore, physical activity is insufficient in grossly 2/3 of the studied population. The only positive point is a tendency of decreasing tobacco use in all age groups. The follow-up study is frustrating because most of the examined criteria get worse in-between check-ups instead of getting better with changes in lifestyle in an informed population.

Conclusions: Asymptomatic diseases or risk factors for non-communicable diseases are extremely frequent in the population examined. The follow-up data shows that huge parts of this group are not sufficiently conscientious of their problems to act up and change their life-style or seek adapted pharmacological prevention. Absolute number of risk factors (prevalence) or pathologies rise evidently with age but incidence (newly discovered pathologies after a first, second or a record of 21 check-ups with our services) rises less. Life-style changes are rare or insufficient to change the pathological value back to normal or therapeutically range. Even with several biases (retrospective design, selection bias, ...) our study puts similar problems forward in the population as ORISCAV. The astonishing (better than national records) results in tobacco use is probably due to a selection of more health-oriented patients and of a higher socio-educative-economic level. Alcohol abuse was very low but probably due to inadequate screening methods. A better health promotion advocating healthier living must be associated with better communication and new motivational tools. Therapeutical education for patients with chronic non-communicable diseases will be the challenge of the near future as their prevalences increase due to ageing of the population and worse individual lifestyles. In this task, efforts must be made on the personal level (health-team with the individual patient) but also on the national level (legal frame work for patient education by multi-professional teams as they exist already in neighbour states).