Cardiovascular risk assessment of Bulgarian urban population: cross-sectional study

To assess the total cardiovascular risk of the Bulgarian urban population.

A representative sample of Bulgarian urban population (n=3810, response rate 68.3%) from five Bulgarian cities was included in a cross-sectional observation study performed in the period 2005-2007. A detailed cardiovascular risk assessment was performed by general practitioners and a total 10-year risk of a fatal cardiovascular event was estimated according to the European Systematic Coronary Risk Evaluation (SCORE, HeartScore.

There were 48.7% of participants in the high risk group (SCORE > or =5%), 24.3% aged 45-54 and more than half aged 55-64 years. Nearly a quarter of the sample had a total cardiovascular risk of over 10% (SCORE > or =10%), whereas 10.1% of the sample had excessively high cardiovascular risk (SCORE > or =15%). In the 65-75 age group, the prevalence of men with excessively high risk was 46.6%, compared with 6.0% in women (P<0.001). Most of the main cardiovascular risk factors were slightly increased or borderline in comparison with clinical thresholds.

Cardiovascular risk is high in a large proportion of Bulgarian urban population, especially in men aged over 65. These findings indicate that a comprehensive national strategy and program for management of cardiovascular diseases is urgently needed. The SCORE method can be well implemented if a higher threshold for a high risk group is defined and smaller target population is planned for extensive and expensive high risk preventive measures.