ABSTRACT
Objective:
To evaluate the effect of stratified management of
cardiovascular diseases risk in
community population based on
China-PAR.
Methods:
It was a single
arm study.
Beijing Jiaotong
University faculty and staff
who participated in annual
health check-up from 2019 to 2021 and met the inclusion/exclusion criteria were enrolled in the study. The general data,
physical examination and
laboratory test results, including age, residence region,
waist circumference, total
cholesterol,
high-density lipoprotein cholesterol (HDL-C),
low-density lipoprotein cholesterol (LDL-C),
blood pressure (BP), taking
antihypertensive drugs,diabetes,
family history of
cardiovascular diseases,were collected. Participants were stratified according to
China-PAR assessment model and then stratified management was carried out. For low-
risk populations,
family doctors provided online guidance or
outpatient follow-up if necessary after their first
interview. For middle and high-
risk groups,
outpatient and
telephone follow-up were arranged in addition to online guidance. Relevant examinations were completed and
drug treatment or
adjustment were given by doctors when necessary. Frequency of
outpatient follow-up for middle and high-
risk groups was different and
patients in these two groups were scored again at the end of 2-year follow-up.
Results:
A total 284 participants were enrolled,197 participants (69.4%) were
males with a age of (46.9±8.8) years. Among them, 205 participants (72.2%) were in low-
risk group, including 136
males (66.3%), and their 10-year
risk of
cardiovascular diseases was (2.5±0.1)%; 59 participants (20.8%) were in middle-
risk group, including 43
males (72.9%), and their 10-year
risk of
cardiovascular diseases was (7.1±0.2)%;20 participants (7.0%) were in high-
risk group,including 18
males (90.0%) and their 10-year
risk of
cardiovascular diseases was (14.0±1.1)%. After 2 years follow-up, the proportion of dietary imbalances and
alcohol drinking,
waist circumference,
blood pressure,
fasting glucose levels and
risk score decreased significantly in high
risk group ( P<0.05). The proportion of dietary imbalances,
waist circumference,
blood pressure, total
cholesterol, and LDL-C levels decreased significantly in medium
risk group ( P<0.05). In high-
risk group, 2 participants (10.0%) converted to low-
risk, 8 participants (40.0%) converted to middle-
risk. In middle-
risk group, 5 participants (8.5%) converted to low-
risk and 7 participants (11.9%) converted to high-
risk.
Conclusion:
The
risk factors and
risk stratification of
cardiovascular disease in
community population can be improved by stratified management based on
China-PAR
risk assessment model.