Trends in Cardiovascular Disease Risk Factor Prevalence and Estimated 10-Year Cardiovascular Risk Scores in a Large Untreated French Urban Population: The CARVAR 92 Study

<div><p>Background</p><p>Surveys measuring effectiveness of public awareness campaigns in reducing cardiovascular disease (CVD) incidence have yielded equivocal findings. The aim of this study was to describe cardiovascular risk factors (CVRFs) changes over the years in an untreated population-based study.</p><p>Methods</p><p>Between 2007 and 2012, we conducted a screening campaign for CVRFs in men aged 40 to 65 yrs and women aged 50 to 70 yrs in the western suburbs of Paris. Data were complete for 20,324 participants of which 14,709 were untreated.</p><p>Results</p><p>The prevalence trend over six years was statistically significant for hypertension in men from 25.9% in 2007 to 21.1% in 2012 (p=0.002) and from 23% in 2007 to 12.7% in 2012 in women (p<0.0001). The prevalence trend of tobacco smoking decreased from 38.6% to 27.7% in men (p=0.0001) and from 22.6% to 16.8% in women (p=0.113). The Framingham 10-year risk for CVD decreased from 13.3 ± 8.2 % in 2007 to 11.7 ± 9.0 % in 2012 in men and from 8.0 ± 4.1 % to 5.9 ± 3.4 % in women. The 10-year risk of fatal CVD based on the European Systematic COronary Risk Evaluation (SCORE) decreased in men and in women (p <0.0001).</p><p>Conclusions</p><p>Over a 6-year period, several CVRFs have decreased in our screening campaign, leading to decrease in the 10-year risk for CVD and the 10-year risk of fatal CVD. Cardiologists should recognize the importance of community prevention programs and communication policies, particularly tobacco control and healthier diets to decrease the CVRFs in the general population.</p></div

Odds ratios and 95% CIs for the relation of between common mental disorder among non-obese subjects at baseline (1984) and the development of global or abdominal obesity at re-survey (1991).

<p>GHQ: 30 items General health questionnaire. BMI: body mass index. WC: waist circumference.</p><p>Multinomial logistic regression models were used with subjects having a body mass index between 18.5 and 24.9 kg/m² (both gender) or a waist circumference < 94 cm (men) /80 cm (women) being the reference.</p><p>Model 1: Adjusted for baseline age</p><p>Model 2: adjusted for baseline age, marital status, socio-economic status, alcohol consumption, tobacco smoking and physical activity.</p><p>Odds ratios and 95% CIs for the relation of between common mental disorder among non-obese subjects at baseline (1984) and the development of global or abdominal obesity at re-survey (1991).</p

Cardiovascular risk factors and estimated 10-year risk for CVD and fatal CVD in adjusted model (population C) (N = 6,504).

<p>*Mean ± SD</p><p>Population C represented the age- and sex-adjusted untreated population.</p><p>Linear trends were verified using the Cochran-Armitage trend test for linearity for categorical data (diabetes, hypertension, high LDL-C, obesity, current smokers), and regression lines for parametric data (10-year risk of fatal CVD and 10-year risk of CVD).</p><p>CVD = cardiovascular disease; LDL-C = low-density lipoprotein-cholesterol</p><p>Cardiovascular risk factors and estimated 10-year risk for CVD and fatal CVD in adjusted model (population C) (N = 6,504).</p

Cardiovascular risk factors and estimated 10-year risk for CVD and fatal CVD in population B (N = 14,709).

<p>*Mean ± SD</p><p>Population B consisted of the total participants who presented to the medical visit and for whom data were complete and who were not taking any antihypertensive or lipid-lowering agents or drug treatment for diabetes</p><p>Linear trends were verified using the Cochran-Armitage trend test for linearity for categorical data (diabetes, hypertension, high LDL-C, obesity, current smokers), and regression lines for parametric data (10-year risk of fatal CVD and 10-year risk of CVD)</p><p>CVD = cardiovascular disease; LDL-C = low-density lipoprotein-cholesterol</p><p>Cardiovascular risk factors and estimated 10-year risk for CVD and fatal CVD in population B (N = 14,709).</p

Association between severe musculoskeletal pain (knee and shoulder) and relevant occupational exposure among men without severe pain in the related region in 2006.

<p>% = proportion; OR = odds ratio; 95% CI = 95% confidence interval.</p>a<p>excluding those with shoulder pain in 2006,</p>b<p>excluding those with knee pain in 2006,</p>c<p>adjusted on age and smoking status,</p>d<p>adjusted on BMI, gender, age and smoking status.</p><p>Association between severe musculoskeletal pain (knee and shoulder) and relevant occupational exposure among men without severe pain in the related region in 2006.</p

Cardiovascular risk factors and estimated 10-year risk for CVD and fatal CVD between 2007 and 2012 in population B.

<p>Cardiovascular risk factors and estimated 10-year risk for CVD and fatal CVD between 2007 and 2012 in population B.</p

Cardiovascular risk factors and estimated 10-year risk for CVD and fatal CVD between 2007 and 2012 in population A.

<p>Cardiovascular risk factors and estimated 10-year risk for CVD and fatal CVD between 2007 and 2012 in population A.</p

Odds ratios and 95% CIs for the relation between general or abdominal obesity among subjects free of common mental disorders at baseline (1984) and the development of common mental disorders at the re-survey study (1991).

<p>GHQ: 30 items General health questionnaire. BMI: body mass index. WC: waist circumference.</p><p>Model 1: Adjusted for baseline age</p><p>Model 2: adjusted for baseline age, marital status, socio-economic status, alcohol consumption, tobacco smoking and physical activity.</p><p>Odds ratios and 95% CIs for the relation between general or abdominal obesity among subjects free of common mental disorders at baseline (1984) and the development of common mental disorders at the re-survey study (1991).</p

Participants selection flow in the HALS.

<p>*These subjects with missing data for any of the following covariates: age, general health questionnaire, marital status, occupational social class, alcohol consumption, smoking status, height, weight and waist circumference.</p

Associations between occupational exposures and musculoskeletal pain, stratified on categories of body mass index (BMI).

<p>% = proportion; OR = odds ratio; 95% CI = 95% confidence interval.</p>a<p>excluding those with shoulder pain in 2006,</p>b<p>excluding those with knee pain in 2006,</p>c<p>adjusted on age and smoking status.</p><p>Associations between occupational exposures and musculoskeletal pain, stratified on categories of body mass index (BMI).</p