Borgström Bolmsjö Beata, Stenman Emelie, Grundberg Anton, Sundquist Kristina
Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
University Clinic Primary Care Skåne, Region Skåne, Sweden.
Arch Public Health. 2024 Nov 28;82(1):228. doi: 10.1186/s13690-024-01457-4.
It is important to identify and evaluate cardiovascular risk factors at an early stage to address them accordingly. Among the younger population, the metabolic syndrome is less common than in older ages. However, each separate metabolic risk factor still has an additive effect on cardiovascular risk factor burden. Non-metabolic risk factors that occur in the younger population include family history, smoking, psychological distress and socioeconomic vulnerability. In 2021 a voluntary health intervention program was introduced in an urban area in Sweden where a cohort of 40-year-olds was invited for cardiovascular risk identification. The aim of this study was to identify how cardiovascular risk factors tend to aggregate in individuals participating in a voluntary health screening program and how the metabolic risk factors associate with non-metabolic cardiovascular risk factors.
This was a cross-sectional study with 1831 participants. Data from questionnaires and baseline measurements were used to calculate the prevalence of metabolic- (blood pressure, lipids, fasting plasma glucose, BMI, waist-hip ratio) and non-metabolic risk factors (family history of CVD, smoking, psychological distress, socioeconomic vulnerability) for CVD. SCORE2 was calculated according to the algorithm provided by the SCORE2 working group and ESC (European Society of Cardiology) Cardiovascular Risk Collaboration. Associations among each of the metabolic risk factors and non-metabolic risk factors were estimated using logistic regression and presented as odds ratios (ORs) with 95% confidence intervals (CIs).
More than half of the study population had at least one metabolic risk factor, and more than 1/3 was considered to be suffering from psychological distress. Furthermore, obesity or central obesity demonstrated individual associations with all of the non-metabolic risk factors in the study; smoking (1.49; 1.32-2.63), family history of CVD (1.41; 1.14-1.73), socioeconomic vulnerability (1.60; 1.24-2.07), and psychological distress (1.40; 1.14-1.72). According to SCORE2 25% of the men were at moderate risk (2.5-7.5%) of developing a cardiovascular event within 5-10 years, but only 2% of the women.
Obesity/central obesity should be a prioritized target in health screening programs. The non-metabolic risk factors, socioeconomic vulnerability, and psychological distress should not be ignored and addressed with adequate guidance to create health equity.
早期识别和评估心血管危险因素并相应地加以应对非常重要。在较年轻人群中，代谢综合征的发生率低于老年人群。然而，每一个单独的代谢危险因素对心血管危险因素负担仍有累加效应。年轻人群中出现的非代谢危险因素包括家族病史、吸烟、心理困扰和社会经济脆弱性。2021年，瑞典一个城市地区推出了一项自愿健康干预计划，邀请一群40岁的人进行心血管危险因素识别。本研究的目的是确定在参与自愿健康筛查计划的个体中，心血管危险因素倾向于如何聚集，以及代谢危险因素与非代谢心血管危险因素如何关联。
这是一项横断面研究，有1831名参与者。来自问卷和基线测量的数据用于计算心血管疾病的代谢危险因素（血压、血脂、空腹血糖、体重指数、腰臀比）和非代谢危险因素（心血管疾病家族史、吸烟、心理困扰、社会经济脆弱性）的患病率。根据SCORE2工作组和欧洲心脏病学会（ESC）心血管风险协作组织提供的算法计算SCORE2。使用逻辑回归估计每个代谢危险因素和非代谢危险因素之间的关联，并以优势比（OR）和95%置信区间（CI）表示。
超过一半的研究人群至少有一个代谢危险因素，超过三分之一的人被认为患有心理困扰。此外，肥胖或中心性肥胖与研究中的所有非代谢危险因素存在个体关联；吸烟（1.49；1.32 - 2.63）、心血管疾病家族史（1.41；1.14 - 1.73）、社会经济脆弱性（1.60；1.24 - 2.07）和心理困扰（1.40；1.14 - 1.72）。根据SCORE2，25%的男性在5至10年内发生心血管事件的风险为中度（2.5 - 7.5%），但女性仅为2%。
肥胖/中心性肥胖应成为健康筛查计划中的优先目标。不应忽视非代谢危险因素、社会经济脆弱性和心理困扰，并应给予适当指导以实现健康公平。
