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Control of cardiovascular risk factors and its determinants in the general population- findings from the STAAB cohort
Theresa Tiffe1,2, Martin Wagner1,2, Viktoria Rücker1
1Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
Insights
Vascular risk factors are common and poorly controlled in the general population. Improving control is crucial for cardiovascular disease prevention, requiring further research into barriers.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Vascular risk factor control is often insufficient in primary care.
- Limited data exists on vascular risk factor control in the general population.
- This study investigates risk factor control in individuals without cardiovascular disease (CVD).
Purpose of the Study:
- To assess the prevalence of adequate vascular risk factor control in the general population.
- To identify determinants associated with the accumulation of uncontrolled vascular risk factors.
- To inform primary prevention strategies for cardiovascular disease.
Main Methods:
- Utilized data from the STAAB Cohort Study (Würzburg, Germany).
- Included 1379 participants aged 30-79 without established CVD.
- Assessed control of hypertension, dyslipidemia, diabetes, physical inactivity, overweight, and smoking against 2016 ESC guidelines.
Main Results:
- High prevalence of physical inactivity (30.8%), overweight (55.2%), and smoking (19.3%).
- Hypertension (31.8%), dyslipidemia (57.6%), and diabetes (3.9%) were prevalent.
- Treatment goals were unmet in over 50% of hypertensive, 37% of hyperlipidemic, and 44% of diabetic participants.
- Insufficient risk control linked to male sex, older age, and lower education levels.
Conclusions:
- Vascular risk factors are highly prevalent in the general population.
- Identification and control of these risk factors are inadequate.
- Significant potential exists to improve adherence to cardiovascular guidelines for primary prevention.
- Further research is needed to address patient- and physician-related barriers to effective risk factor management.
Background:
While data from primary care suggest an insufficient control of vascular risk factors, little is known about vascular risk factor control in the general population. We therefore aimed to investigate the adoption of adequate risk factor control and its determinants in the general population free of cardiovascular disease (CVD).
Methods:
Data from the Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) Cohort Study, a population-based study of inhabitants aged 30 to 79 years from the general population of Würzburg (Germany), were used. Proportions of participants without established CVD meeting targets for risk factor control recommended by 2016 ESC guideline were identified. Determinants of the accumulation of insufficiently controlled vascular risk factors (three or more) were assessed.
Results:
Between December 2013 and April 2015, 1379 participants without CVD were included; mean age was 53.1 ± 11.9 years and 52.9% were female; 30.8% were physically inactive, 55.2% overweight, 19.3% current smokers. Hypertension, dyslipidemia, and diabetes mellitus were prevalent in 31.8%, 57.6%, and 3.9%, respectively. Treatment goals were not reached despite medication in 52.7% of hypertensive, in 37.3% of hyperlipidemic and in 44.0% of diabetic subjects. Insufficiently controlled risk was associated with male sex (OR 1.94, 95%CI 1.44-2.61), higher age (OR for 30-39 years vs. 70-79 years 4.01, 95%CI 1.94-8.31) and lower level of education (OR for primary vs. tertiary 2.15, 95%CI 1.48-3.11).
Conclusions:
In the general population, prevalence of vascular risk factors was high. We found insufficient identification and control of vascular risk factors and a considerable potential to improve adherence to cardiovascular guidelines for primary prevention. Further studies are needed to identify and overcome patient- and physician-related barriers impeding successful control of vascular risk factors in the general population.
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