Małgorzata Setny1, Piotr Jankowski2,3, Karol Kamiński4, Zbigniew Gąsior5, Maciej Haberka5, Danuta Czarnecka6, Andrzej Pająk7, Paweł Kozieł6, Karolina Szóstak-Janiak5, Emilia Sawicka4, Zofia Stachurska4, Dariusz A Kosior8,9. 1. Clinical Cardiology Center, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland. malgorzata.setny@cskmswia.gov.pl 2. Department of Internal Medicine and Geriatric Cardiology, Center of Postgraduate Medical Education, Warsaw, Poland 3. Department of Epidemiology and Health Promotion, School of Public Health, Center of Postgraduate Medical Education, Warsaw, Poland 4. Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland 5. Department of Cardiology, Medical University of Silesia, Katowice, Poland 6. First Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland 7. Department of Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland 8. Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland 9. Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
Abstract
INTRODUCTION: Adherence to health‑promoting behaviors intended to mitigate modifiable risk factors plays an important role in secondary cardiovascular prevention. OBJECTIVES: We aimed to evaluate sex differences in the prevalence and control of risk factors in patients with coronary heart disease (CHD). PATIENTS AND METHODS: The study included 1236 patients who experienced acute coronary syndrome or coronary revascularization within the last 6 to 24 months. Definitions of risk factors and treatment goals were based on the 2016 European Society of Cardiology guidelines on cardiovascular prevention. RESULTS: The prevalence of modifiable risk factors in both sexes was high, and their control inadequate. Women were older (P <0.001) and had a higher accumulation of multiple cardiovascular risk factors than men (P = 0.036). They more frequently had central obesity (P <0.001) and reduced values of glomerular filtration rate (P <0.001). Women more often experienced anxiety (P <0.001), reported lower levels of education (P <0.001) and lower income (P = 0.001), and those in the youngest age group were more likely to be exposed to second‑hand smoking (P = 0.01). A large fraction of the study patients, men and women alike, did not meet the recommended therapeutic goals. For both sexes, participation in cardiac rehabilitation programs was associated with more frequent attainment of the recommended level of physical activity (P = 0.046) and smoking cessation (P = 0.01). CONCLUSIONS: The prevalence of cardiovascular risk factors in patients with CHD is high, especially in women. Therapeutic goals are met infrequently in both sexes. This situation calls for widening the access to educational programs and paying greater attention to their proper implementation.
INTRODUCTION: Adherence to health‑promoting behaviors intended to mitigate modifiable risk factors plays an important role in secondary cardiovascular prevention. OBJECTIVES: We aimed to evaluate sex differences in the prevalence and control of risk factors in patients with coronary heart disease (CHD). PATIENTS AND METHODS: The study included 1236 patients who experienced acute coronary syndrome or coronary revascularization within the last 6 to 24 months. Definitions of risk factors and treatment goals were based on the 2016 European Society of Cardiology guidelines on cardiovascular prevention. RESULTS: The prevalence of modifiable risk factors in both sexes was high, and their control inadequate. Women were older (P <0.001) and had a higher accumulation of multiple cardiovascular risk factors than men (P = 0.036). They more frequently had central obesity (P <0.001) and reduced values of glomerular filtration rate (P <0.001). Women more often experienced anxiety (P <0.001), reported lower levels of education (P <0.001) and lower income (P = 0.001), and those in the youngest age group were more likely to be exposed to second‑hand smoking (P = 0.01). A large fraction of the study patients, men and women alike, did not meet the recommended therapeutic goals. For both sexes, participation in cardiac rehabilitation programs was associated with more frequent attainment of the recommended level of physical activity (P = 0.046) and smoking cessation (P = 0.01). CONCLUSIONS: The prevalence of cardiovascular risk factors in patients with CHD is high, especially in women. Therapeutic goals are met infrequently in both sexes. This situation calls for widening the access to educational programs and paying greater attention to their proper implementation.