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A Cross-Sectional Observational Study on the Prediction of Cardiovascular Events and Mortality from Cardiovascular
A Sivkov1, N Chernus2, A Spaska3
1Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Institute of Clinical Medicine named after N.V. Sklifosovsky, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Insights
Social adversity significantly increases cardiovascular disease risk, particularly for certain immigrant groups. This highlights the need to consider social determinants in patient management strategies for better cardiovascular health outcomes.
Area of Science:
- Cardiology
- Public Health
- Sociology
Background:
- Cardiovascular diseases (CVD) are influenced by various risk factors beyond traditional ones.
- Factors like nationality, psychological traits, and social status are increasingly recognized as significant.
- Understanding these determinants is crucial for developing patient-centered management strategies.
Purpose of the Study:
- To assess the cumulative impact of adverse socio-demographic factors on cardiovascular health.
- To explore the association between social determinants and major cardiovascular risk factors, inflammation, and subclinical atherosclerosis.
- To identify specific populations at higher risk for cardiovascular diseases based on social and demographic factors.
Main Methods:
- Utilized a "social determinants" questionnaire adapted from the American MESA study.
- Assessed the impact of identified adverse socio-demographic factors on cardiovascular risk.
- Analyzed associations between social determinants and cardiovascular risk factors, systemic inflammation, subclinical atherosclerosis, and CVD.
Main Results:
- Increasing social adversity correlated with higher odds of developing most cardiovascular risk factors, excluding dyslipidemia.
- Smoking showed the strongest link to poor social determinants (OR, 2.67).
- Higher social adversity (quartile 4) was linked to increased C-reactive protein (OR, 1.33) and CVD risk (RR, 1.31).
Conclusions:
- Cardiovascular disease risk is elevated in immigrants from the North Caucasus and Central Asia compared to other groups.
- These ethnic groups showed a significantly higher prevalence of CVD risk factors in the highest adversity quartile (43.0% vs 29.2%).
- Social determinants play a critical role in cardiovascular disease risk stratification and management.
Background:
Currently, additional risk factors for cardiovascular diseases (CVD), including nationality, psychological characteristics, and social status, are under consideration. Therefore, there is a need for the exploration and assessment of the contribution and consideration of the aforementioned factors to determine patient-oriented management strategies.
Methods:
Participants underwent a survey using the "social determinants" questionnaire, which was developed and initially utilized in the context of the extensive American MESA study. Based on the identified set of adverse socio-demographic factors during the survey, an assessment of their cumulative impact on major cardiovascular risk factors, systemic inflammation, subclinical atherosclerosis, and cardiovascular diseases was conducted.
Results:
An association was established between increasing social adversity and an elevated likelihood of developing all cardiovascular risk factors, except for dyslipidemia. Smoking exhibited the most significant association with deteriorating health-related social determinants (odds ratio [OR], 2.67 for quartile 4 versus quartile 1 [95% CI, 2.13-3.34]). Compared to patients in quartile 1 of health-related social determinants, those in quartile 4 had a one-third increased risk of elevated C-reactive protein (OR, 1.33 [95% CI, 1.11-1.60]) and a 31% increased risk of all cardiovascular diseases (risk ratio, 1.31 [95% CI, 1.03-1.67]).
Conclusions:
The risk of cardiovascular diseases was higher in immigrants from the North Caucasus republics and Central Asia compared to the indigenous population and immigrants from Eastern Asia. For representatives of the mentioned ethnic groups, the prevalence was significantly higher in quartile 4 than in quartile 1: 43.0% versus 29.2%, respectively (p < 0.001).
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