Cardiovascular risk factors, lifestyle, and social determinants: a cross-sectional population study.

BACKGROUND: The influence of socioeconomic development is often disregarded in epidemiological studies into the prevalence of cardiovascular risk factors. AIM: To analyse the relationship between major cardiovascular risk factors and socioeconomic indicators. DESIGN AND SETTING: Cross-sectional, population-wide study in primary care practices in the health area of Don Benito-Villanueva de la Serena, Badajoz, Extremadura, Spain. METHOD: A total of 2833 people aged 25-79 years (mean age 51.2 years), representative of the population, participated in the study. The prevalence and odds ratios (ORs) were calculated for diabetes, arterial hypertension, obesity, hypercholesterolaemia, smoking, and sedentary behaviour, according to level of education and employment status. RESULTS: A high prevalence of cardiovascular risk factors related to the level of education and employment status. Females who had not studied at university had a higher risk of obesity (OR = 2.5, 95% confidence interval [CI] = 1.5 to 4.2), smoking (OR 2.5, 95% CI = 1.7 to 3.7), and sedentary behaviour (OR = 2.5, 95% CI = 1.5 to 3.9) than females with a university education. Males who had not studied at university showed an increased risk of smoking (OR = 2.1, 95% CI = 1.4 to 3.1), arterial hypertension (OR = 1.5, 95% CI = 1.0 to 2.4), hypercholesterolaemia (OR = 1.5, 95% CI = 1.0 to 2.2), and obesity (OR = 1.5, 95% CI = 1.0 to 2.3) than males with a university education. The risk of obesity was higher in unemployed females than those in paid employment (OR =1.4, 95% CI = 1.1 to 1.9), but they showed a lower risk of smoking (OR = 0.7, 95% CI = 0.5 to 0.9). CONCLUSION: The study results confirm an inverse association between the level of education and the prevalence of cardiovascular risk factors. Public health studies and interventions are needed to understand this association and develop interventions targeted at the population that is at greatest risk.

[Prevalence alcohol consumption and cardiovascular risk factors in an Extremadura health area. Hermex study]. / Prevalencia de consumo de alcohol y factores de riesgo cardiovascular en un área sanitaria de Extremadura. Estudio Hermex.

OBJECTIVES: Alcohol has been associated with a lower risk of developing cardiovascular disease. It has been our objective to determine the prevalence of use of alcohol and its association with the presence of cardiovascular risk factors (CRF). DESIGN: Cross-sectional study. SETTING: Don Benito-Villanueva de la Serena health area (Badajoz). PARTICIPANTS: We selected a random sample of 25 to 79 year olds, representative of the population. METHODS: We collected a survey about the history of cardiovascular risk factors and alcohol consumption in the previous seven days. We measured blood pressure and a fasting blood sample was obtained. The association of alcohol consumption with the different CRF was studied by multivariate analysis, adjusting for different variables. RESULTS: A total of 2833 subjects participated, with a mean age 51.2 (SD 14.7) years and 46.5% males. We detected 36.1% (95% CI 34.4 to 37.9) of alcohol consumers. The overall prevalence and consumption medium or high risk was 63.2% and 15.2% in men, and 12.6% and 1.5% in women, respectively. In men, consumption of medium-high risk was associated with hypercholesterolemia, hypertension and smoking. In women, low-risk consumption was associated with a lower prevalence of obesity and hypertension and higher smoking. CONCLUSIONS: We found a lower prevalence of alcohol use, especially in women, compared to the Spanish national average. The consumption of medium-high risk mainly affects men and is associated with increased cardiovascular risk. In women at low risk consumption is associated with a lower prevalence of certain CRF and increased smoking.

[Risk factor treatment and control in relation to coronary disease risk in the Spanish population of the DARIOS Study]. / Tratamiento y control de los factores de riesgo según el riesgo coronario en la población española del estudio DARIOS.

INTRODUCTION AND OBJECTIVES: The treatment and control of cardiovascular risk factors both play key roles in primary prevention. The aim of the present study is to analyze the proportion of primary prevention patients aged 35-74 years being treated and controlled in relation to their level of coronary risk. METHODS: Pooled analysis with individual data from 11 studies conducted in the first decade of the 21st century. We used standardized questionnaires and blood pressure measures, glycohemoglobin and lipid profiles. We defined optimal risk factor control as blood pressure < 140/90 mm Hg and glycohemoglobin <7%. In hypercholesterolemia, we applied both the European Societies and Health Prevention and Promotion Activities Programme criteria. RESULTS: We enrolled 27 903 participants (54% women). Drug treatments were being administered to 68% of men and 73% of women with a history of hypertension (P<.001), 66% and 69% respectively, of patients with diabetes (P=.03), and 39% and 42% respectively, of those with hypercholesterolemia (P<.001). Control was good in 34% of men and 42% of women with hypertension (P<.001); 65% and 63% respectively, of those with diabetes (P=.626); 2% and 3% respectively, of patients with hypercholesterolemia according to European Societies criteria (P=.092) and 46% and 52% respectively, of those with hypercholesterolemia according to Health Prevention and Promotion Activities Programme criteria (P<.001). The proportion of uncontrolled participants increased with coronary risk (P<.001), except in men with diabetes. Lipid-lowering treatments were more often administered to women with ≥ 10% coronary risk than to men (59% vs. 50%, P = 0,024). [corrected] CONCLUSIONS: The proportion of well-controlled participants was 65% at best. The European Societies criteria for hypercholesterolemia were vaguely reached. Lipid-lowering treatment is not prioritized in patients at high coronary risk.