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The Burden of Cardio-Cerebrovascular Risk Factors: Differences Between Individual Risk and Population Risk
Eduardo Capuano1, Federica Marchese2, Rocco Capuano3
1Department of Cardiology and UTIC, "Gaetano Fucilo Hospital" Mercato S. Severino, Azienda Ospedaliera Universitaria Integrata di Salerno, Salerno, Italy.
Insights
Cardio-cerebrovascular disease risk factors significantly impact major cardiovascular events. Identifying high-impact factors like systolic blood pressure is crucial for effective prevention strategies.
Area of Science:
- Epidemiology
- Cardiovascular Medicine
- Public Health
Background:
- Cardio-cerebrovascular (CCV) disease poses a major global health challenge, leading to significant mortality and morbidity.
- Effective mitigation of CCV risk factors is paramount for reducing disease incidence at both individual and population levels.
- Evidence-based medicine and epidemiological studies are vital for optimizing interventions against CCV disease.
Purpose of the Study:
- To elucidate the burden of various risk factors in the development of CCV events.
- To contribute to understanding the etiological role of risk factors in individual patients and the broader community.
Main Methods:
- A longitudinal survey conducted in 1999 as part of the "VIP (Valle dell'Irno Prevention) Project" collected clinical data and risk factor information.
- Assessed the incidence of Major Adverse Cardiovascular Events (MACE).
- Calculated prevalence, absolute risk, odds ratio (OR), additional risk (AR), population attributable risk (PAR), and population attributable risk fraction (PAF) for each risk factor.
Main Results:
- Significant differences between MACE and non-MACE groups were observed for glomerular filtration rate (GFR), glucose, systolic blood pressure (SBP), BMI, diastolic blood pressure (DBP), cholesterol, triglycerides, creatinine, and uric acid.
- GFR, glucose, and SBP exhibited the highest Odds Ratios (OR).
- Systolic blood pressure (29.6%), triglyceridemia (19.4%), and metabolic syndrome (18.3%) demonstrated the greatest population attributable risk fraction (PAF) impact on MACE.
Conclusions:
- The impact of CCV risk factors on MACE varies significantly when assessed at the individual versus population level.
- Physicians must consider these distinct perspectives when implementing interventions to reduce CCV events.
Introduction:
Cardio-cerebrovascular (CCV) disease contributes significantly to the global burden of disease, with dramatic consequences in terms of mortality and general health. Mitigate CCV risk factors is the key to reduce individual and population risk of CCV events. Evidence-based medicine and epidemiological investigations of risk factors are essential to optimize actions.
Aim:
To contribute to the knowledge of the burden of risk factors in determining CCV events in the individual patient and in the community.
Methods:
Clinical data and risk factors were collected through a longitudinal survey (1999) as part of a larger epidemiology and cardiovascular prevention project, namely the "VIP (Valle dell'Irno Prevention) Project". We assessed the incidence of major cardiovascular events (MACE) and for each risk factor we calculated: prevalence, absolute risk, odds ratio (OR), additional risk (AR) = risk of exposed to the risk factor - risk of non-exposed, population attributable risk (PAR) = additional risk * prevalence, population attributable risk fraction (PAF) = PAR/total incidence of the disease.
Results:
Comparing the MACE group with the non-MACE group, a statistically significant difference was found for the following: glomerular filtration rate (GFR), glucose and systolic blood pressure (SBP), BMI, diastolic blood pressure (DBP), cholesterol, triglycerides, creatinine and uric acid. GFR, glucose and SBP showed the highest OR. Age, creatinine, glycemia, SBP and uric acid were independent predictor of MACE. When calculating the PAF, the CCV risk factors with the greatest impact on MACE were: SBP (29.6%), triglyceridemia (19.4%) and metabolic syndrome (18.3%).
Conclusion:
The burden of risk factors on MACE changes substantially according to whether it is calculated in the single patient or in the population. It is crucial for physicians to take these differences into account when applying their own intervention to reduce CCV events.
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