scholarly journals Cross-sectional survey describing general practitioners’ absolute cardiovascular disease risk assessment practices and their relationship to knowledge, attitudes and beliefs about cardiovascular disease risk in Queensland, Australia

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e033859
Author(s):  
Kim Greaves ◽  
Anita Smith ◽  
Jason Agostino ◽  
Kuhan Kunarajah ◽  
Tony Stanton ◽  
...  

ObjectivesTo describe general practitioners’ (GPs’) absolute cardiovascular disease risk (ACVDR) self-reported assessment practices and their relationship to knowledge, attitudes and beliefs about ACVDR.DesignCross-sectional survey with opportunistic sampling (October–December 2017).SettingSunshine Coast region, Queensland, Australia.Participants111 GPs responded to the survey.Primary and secondary outcome measuresProportion of GPs reporting a high (≥80%) versus moderate (60%–79%)/low (<60%) percentage of eligible patients receiving ACVDR assessment; proportion agreeing with statements pertaining to knowledge, attitudes and beliefs about ACVDR and associations between these factors.ResultsOf the 111 respondents, 78% reported using the Australian ACVDR calculator; 45% reported high, 25% moderate and 30% low ACVDR assessment rates; >85% reported knowing how to use ACVDR assessment tools, believed assessment valuable and were comfortable with providing guideline-recommended treatment. Around half believed patients understood the concept of high risk and were willing to adopt recommendations. High assessment rates (vs moderate/low) were less likely among older GPs (≥45 vs ≤34 years, age-adjusted and sex-adjusted OR (aOR) 0.36, 95% CI 0.12 to 0.97). Those who answered knowledge-based questions about the guidelines incorrectly had lower assessment rates, including those who answered questions on patient eligibility (aOR 0.13, 95% CI 0.02 to 1.11). A high assessment rate was more likely among GPs who believed there was sufficient time to do the assessment (aOR 3.79, 95% CI 1.23 to 11.61) and that their patients were willing to undertake lifestyle modification (aOR 2.29, 95% CI 1.02 to 5.15). Over 75% of GPs agreed better patient education, nurse-led assessment and computer-reminder prompts would enable higher assessment rates.ConclusionsAlthough the majority of GPs report using the ACVDR calculator when undertaking a CVD risk assessment, there is a need to increase the actual proportion of eligible patients undergoing ACVDR assessment. This may be achieved by improving GP assessment practices such as GP and patient knowledge of CVD risk, providing sufficient time and nurse-led assessment.

2019 ◽  
Vol 11 (2) ◽  
pp. 138-146
Author(s):  
Leila Azadbakht ◽  
Fahime Akbari ◽  
Mostafa Qorbani ◽  
Mohammad Esmaeil Motlagh ◽  
Gelayol Ardalan ◽  
...  

Introduction: This cross-sectional study aimed to assess the association between cardiovascular disease (CVD) risk factors and dinner consumption in a nationally representative sample of Iranian adolescents. Methods: The present study was conducted on 5642 adolescents aged 10-18 years old in 27 provinces in Iran. The subjects were included applying by multistage random cluster sampling. Participants who ate ≥5 dinners during a week were considered as a dinner consumer. Results: Among 5642 subjects, 1412 (25%) did not consume dinner. Dinner consumers were less likely to be overweight or obese (P < 0.001) and abdominally obese (P < 0.001) as well as to have an abnormal level of HDL-C (P = 0.02). Dinner skipper youths had a higher risk for overweight or obesity (odds ratio [OR]: 1.62; 95% CI: 1.39-1.89) and abdominal obesity (OR: 1.59; 95% CI: 1.36-1.85) which remained significant after adjusting confounding factors (P <0001). No relationship was observed between dinner consumption and the rest of the CVD risk factors, neither in crude nor in adjusted models. A higher proportion of dinner-consumer adolescents had no CVD risk factors in comparison to dinner-skipper subjects (31.1% vs. 28%). Conclusion: Eating dinner might be inversely associated with some CVD risk factors among Iranian adolescents. Further prospective studies will need to prove this theory.


Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 73
Author(s):  
Trine Moholdt ◽  
Brooke L. Devlin ◽  
Tom Ivar Lund Nilsen

Overall potato consumption is positively associated with cardiovascular disease (CVD) risk factors, such as measures of adiposity. However, few studies have explicitly stated the preparation method of potatoes, which may impact these associations. We examined cross-sectional associations between self-reported dietary intake of boiled potatoes and levels of body mass index, waist circumference, blood pressure, and blood lipids among 43,683 participants in the HUNT Study, Norway in 2006–2008. All estimated associations were adjusted for possible imbalance in age, sex, physical activity, smoking, intake of other foods and alcohol between categories of boiled potato consumption. Overall, there were no large differences in mean levels of CVD risk factors between categories of boiled potato consumption. Compared to the reference group of individuals who consumed boiled potatoes less than once/week, those who reported eating boiled potatoes every day had slightly higher prevalence of high waist circumference (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.05–1.29), high triglycerides levels (OR 1.20, 95% CI 1.07–1.34), and metabolic syndrome (OR 1.17, 95% CI 1.03–1.33). In summary, consumption of boiled potatoes showed weak and small associations with the CVD risk factors under study, but the cross-sectional design prevents us from drawing any firm conclusions.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Camila X. Romero ◽  
Tomas E. Romero ◽  
Judith C. Shlay ◽  
Lorraine G. Ogden ◽  
Dana Dabelea

Objectives. To examine trends in the prevalence and disparities of traditional cardiovascular disease (CVD) risk factors among the major race/ethnic groups in the USA: non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), and Mexican Americans (MAs).Methods. We used cross-sectional trend analysis in women and men aged 25–84 years participating in the NHANES surveys, years 1988–1994 (n=14,341) and 1999–2004 (n=12,360).Results. The prevalence of obesity and hypertension increased significantly in NHW and NHB, both in men and women; NHB had the highest prevalence of obesity and hypertension in each time period. Diabetes prevalence showed a nonsignificant increasing trend in all groups and was higher in MA in both periods. Smoking significantly decreased in NHW men and NHB, the latter with the largest decline although the highest prevalence in each period; no changes were noted in MA, who had the lowest prevalence in both periods. Race/ethnic CVD risk factors disparities widened for obesity and hypercholesterolemia, remained unchanged for diabetes and hypertension, and narrowed for smoking.Conclusions. The increasing prevalence of obesity and hypertension underscores the need for better preventive measures, particularly in the NHB group that exhibits the worst trends. The decline in smoking rates may offset some of these unfavorable trends.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0254590
Author(s):  
Qiqi Shi ◽  
Ran Wang ◽  
Huifeng Zhang ◽  
Yaping Shan ◽  
Ming Ye ◽  
...  

SUA is associated with cardiovascular disease and cardiovascular disease risk factors in adults, including chronic kidney disease, coronary artery disease, stroke, diabetes mellitus, preeclampsia, and hypertension. A cross-sectional study was carried out among 11219 adolescents 12 to 18 years of age examined in the 2001–2018 National health and Nutrition Examination Survey. We examined the association between SUA and CVD risk factors. The overall mean SUA level was 5.00±1.24mg/dl. Restricted cubic spline analysis results revealed SUA was inversely associated with HDL-C and SPISE and positively associated with TC, TG, LDL-C, nonHDL-C, insulin, SBP and DBP after full adjustment. Multiple logistic analyses showed SUA level was independently associated with high TC, high TG, high nonHDL-C and low HDL-C (all p<0.05). Furthermore, females in the highest quartile of SUA had significantly higher odds for elevated BP (OR = 2.38, 95%CI:1.02–5.54, P<0.05) and high TC (OR = 2.22, 95%CI: 1.49–3.30, P<0.001), which not observed in males. Increased levels of SUA were associated with increased odds of various cardiovascular risk factors in American adolescents, especially females.


2009 ◽  
Vol 1 (3) ◽  
pp. 226
Author(s):  
Sarah Waldron ◽  
Margaret Horsburgh

BACKGROUND AND CONTEXT: Evidence has shown the effectiveness of risk factor management in reducing mortality and morbidity from cardiovascular disease (CVD). An audit of a nurse CVD risk assessment programme undertaken between November 2005 and December 2008 in a Northland general practice. METHOD : A retrospective audit of CVD risk assessment with data for the first entry of 621 patients collected exclusively from PREDICT-CVDTM, along with subsequent data collected from 320 of these patients who had a subsequent assessment recorded at an interval ranging from six months to three years (18 month average). RESULTS: Of the eligible population (71%) with an initial CVD risk assessment, 430 (69.2%) had a five year absolute risk less than 15%, with 84 (13.5%) having a risk greater than 15% and having not had a cardiovascular event. Of the patients with a follow-up CVD risk assessment, 34 showed improvement. Medication prescribing for patients with absolute CVD risk greater than 15% increased from 71% to 86% for anti-platelet medication and for lipid lowering medication from 65% to 72% in the audit period. STRATEGIES FOR IMPROVEMENT: The recently available ‘heart health’ trajectory tool will help patients become more aware of risks that are modifiable, together with community support to engage more patients in the nurse CVD prevention programme. Further medication audits to monitor prescribing trends. LESSONS: Patients who showed an improvement in CVD risk had an improvement in one or more modifiable risk factors and became actively involved in making changes to their health. KEYWORDS: Cardiovascular disease risk assessment; nurse clinics; audit


2021 ◽  
pp. 095646242110293
Author(s):  
Matthias C Mueller ◽  
Susanne Usadel ◽  
Winfried V Kern ◽  
Andreas Zirlik ◽  
Qian Zhou

Because people living with HIV (PLWH) have an elevated risk for cardiovascular disease (CVD), prevention of CVD should be integrated in to HIV care. In this study, we compared the agreement between three risk scores and evaluated the indication for statin therapy based on guidelines of the American Heart Association and European AIDS Clinical Society. This study is a cross-sectional, single-center study. All PLWH ≥ 30 years without CVD and statin therapy were consecutively enrolled. Agreement between CVD risk estimates was assessed using Cohen’s kappa coefficient. Of 488 PLWH, 41.2% were female with a median age of 47.8 years. D:A:D-R classified the highest proportion of patients in the categories of high/very high risk for CVD (17.8%) compared to SCORE (4.7%) and FRS (13.7%). D:A:D-R and SCORE (κ = 0.11) as well as D:A:D-R and FRS (κ = 0.33) showed poor agreement. Based on different CVD risk equations and guidelines, indication for statin therapy ranged from 34.8% to 92.0% of patients. In conclusion, a high proportion of PLWH is at high risk for CVD likely underestimated by treating physicians. Inconsistencies in the evaluation of CVD risk and primary prophylaxis should be tackled by an interdisciplinary approach.


2015 ◽  
Vol 2 (4) ◽  
pp. 91 ◽  
Author(s):  
Mohammed Alim ◽  
Rakesh K. Sahay ◽  
Nuwairah Hafiz ◽  
B. Prabhakar ◽  
Mohammed Ibrahim

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong><span lang="EN-US"> Recently non-alcoholic fatty liver disease (NAFLD) has been suggested as independent cardiovascular (CVD) risk factor and many studies have shown strong links between NAFLD and CVD but NAFLD has not been related to cardiovascular mortality independently on a long term follow up. Inflammation and oxidative stress is well recognized factors for NALFD which lead to many interrelated factors contributing to cardiovascular risk. Aim: To study the cardiovascular disease risk in diabetes and metabolic syndrome patients with and without NAFLD using different risk assessment calculators.</span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>This was a single center, prospective cross sectional study. 62 patients with diabetes and metabolic syndrome attending the endocrinology &amp; gastroenterology clinics of Osmania General Hospital were enrolled in to the study with 31 patients in group A (NAFLD) and 31 patients in group B (Non-NAFLD). Patients were diagnosed with fatty liver by ultrasound examination.  </p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>The groups were individually evaluated for cardiovascular risk assessment by PROCAM risk score, atherosclerotic cardiovascular disease (ASCVD) score and atherosclerosis Index. The means ± standard(%) deviation of Procam risk score for NAFLD group was 6.00 ± 1.00 and for Non NAFLD group it was 10.00 ± 2.00 (p=0.039). ASCVD risk score shows 5.11 ± 1.12 for NAFLD and Non NAFLD group showed 8.25 ± 2.18 (p=0.235). The Atherosclerosis index for NAFLD group was 0.24 ± 0.03 and Non NAFLD 0.18 ± 0.04 (p=0.785). The QRsik2 score for NAFLD and Non-NAFLD patients was 13.16 ± 7.56 and 17.45 ± 10.36.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>There was no difference in CVD risk assessment when assessed with different calculators in this population.</p>


2011 ◽  
Vol 20 (2) ◽  
Author(s):  
Ane Kristiansen Solbraa ◽  
Asgeir Mamen ◽  
Geir Kåre Resaland ◽  
Jostein Steene- Johannessen ◽  
Einar Ylvisåker ◽  
...  

<strong><em>Background</em>:</strong> Physical activity (PA) and high cardiorespiratory fitness (CRF) are associated with reduced risk of cardiovascular disease (CVD). Sogn og Fjordane County has the reputation of being the most healthy county in Norway. The level of PA and/or CRF may partly explain this health status. However, only one study with regional objectively measured PA data and one study with regional data on CRF currently exist. Thus, the aim of this study was to describe levels of PA, CRF and CVD risk factors in an adult population in the county of Sogn og Fjordane.<em><strong> Methods:</strong> </em>In total, 314 (♀:178 ♂:136) 40-42-year-olds and 308 (♀:175 ♂:133) 53-55-yearolds participated in this cross-sectional study. PA was measured objectively by accelerometry, while CRF was measured directly. <em><strong>Results:</strong></em> There were no sex differences in total PA level. For the 40-42-year-olds, women spent 6.0min/day [95% CI: –11.7 to –0.3] less participating in moderate PA compared to men. For the 53-55- year-olds, women were inactive for 36.0 min/day [95% CI: –55.2 to –16.8] less and they participated in light activity for 26.4 min/day [95% CI: 7.7 to 45.2] more than men. In total, 30.0% [95% CI: 24.8 to 35.2] of the 40-42-year-olds and 30.2% [95% CI: 25.0 to 35.4] of the 53-55-year-olds met the Norwegian recommendations<br />for PA. CRF was 49.0 ml·kg–1·min–1 for men and 41.6 ml·kg–1·min–1 for women for the 40-42-year-olds. For 53-55-year-olds CRF was 41.2 ml·kg–1·min–1 for men and 33.9 ml·kg–1·min–1 for women.<em><strong> Conclusions:</strong></em> These results suggest that the level of PA and CRF are higher compared to other available data. This might explain the advantageous health status in Sogn og Fjordane.


2018 ◽  
Vol 15 (2) ◽  
pp. 9-14 ◽  
Author(s):  
Tiago Adrega ◽  
Joana Ribeiro ◽  
Luis Santos ◽  
Jose A Santos

Background and Aims: Nepal is a developing country with increasing rates of cardiovascular disease (CVD), and the recent 2015 earthquakes imposed critical social and epidemiological effects to the population. This study aims to assess the prevalence of CVD risk factors, social health behaviours and atrial fibrillation (AF) in a native population from a remote Nepalese village that was the epicentre of the May 2015 earthquake.Methods: Observational, cross-sectional study, addressing the population of dislodged inhabitants of Sindhupalchok. Data was collected during an opportunistic clinical screening in the midst of a humanitarian medical mission and consisted of demographic, anthropometric and medical data.Results: A total of 270 patients were assessed (41% in a temporary settlement with continuous organisational support and 59% in the remote village with less back-up). Among adults, 89% had low fruit consumption, 49% were overweight or had augmented waist circumference, 42% had smoking habits, 57% consumed alcohol regularly, 22% had high blood pressure measurements and 5% had abnormal glycaemic levels. An 11% prevalence of AF was found among the elderly.Conclusions: The studied population has a high prevalence of CVD risk factors, poor health behaviours and a significant prevalence of AF among the elderly representatives. International partnering and humanitarian work might be important tools to assess the population’s needs and implement corrective measures.


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