Trends in cardiovascular risk factors · Trends in cardiovascular risk factors Panos Stafylas, MD,...

Trends in cardiovascular risk factors

Panos Stafylas, MD, MSc, PhD

Cardiologist/ΗΤΑ ConsultantScientific Director, HealThink

Thessaloniki, Greece

Declaration of interest

• I have nothing to declare

Eurostat Database (data refer to Cyprus, 2014).

CVDs remain the main cause of mortality

5.500 θάνατοι

GBD 2017, Causes of Death Collaborators. Lancet 2018

CVD main cause of death for

male 35+ and female 55+

European Heart Journal, Volume 37, Issue 42, 7 November 2016, Pages 3232–3245, https://doi.org/10.1093/eurheartj/ehw334

The content of this slide may be subject to copyright: please see the slide notes for details.

Figure 3 Estimated DALYs per 1000 population for all

cardiovascular diseases, coronary heart disease and stroke, WHO

...

Cyprus: 31.820 DALYs

~ 37 DALYs/1000 individuals

(23%)

GBD: Leading CVD Risk Factors

GBD 2017, Risk Factor Collaborators, Lancet 2018

GBD 2017, Risk Factor Collaborators, Lancet 2018

Τεκμηριωμένοι παράγοντες κινδύνου για ΣΝ

1. Ηλικία

2. Φύλο

3. Οικογενειακό ιστορικό

4. Γονότυπος

1. Αρτηριακή υπέρταση

2. Υπερλιπιδαιμία

3. Σακχαρώδης διαβήτης

4. Κάπνισμα

5. Παχυσαρκία

6. Διατροφή

7. Καθιστική ζωή

8. Ψυχοκοινωνικοί παράγοντες

Mean systolic blood pressure (mmHg), 1980-2014

ESC CVD Statistics 2017

Prevalence EU 18.3% / 27.3%(F / M, high income EU countries 2014)

Prevalence CY 15.8% / 23.5%

Η μείωση της ΑΠ κατά 2 mmΗg μειώνει τον κίνδυνο κατά 7–10%

• Μετα-ανάλυση 61 προοπτικών μελετών παρατήρησης

• 1 εκατομμύριο ενήλικες

• 12.7 εκατομμύρια ανθρωπο-έτη

2 mmHg

μείωση της μέσης ΣΑΠ

- 10% θνητότητα από ΑΕΕ

- 7% θνητότητα από Ισχ. Καρδιοπάθεια

Lewington et al. Lancet 2002;360:1903–13

Υπερλιπιδαιμία

Lewington et al. Lancet 2007 NCEP report. Circulation 2004

Cholesterol(≥5.0 mmol/L / ≥ 6.2 mmol/L, M/F)

Prevalence CY:

• 57.1% (>5 mmol/L)

• 17.7% (>6.2 mmol/L)

Vs ESC 52.9% / 16.3%

DM not only substantially increases the risk of CVD

but also magnifies the effect of other RF for CVD

MRFIT=Multiple Risk Factor Intervention Trial

*Risk factors analyzed: smoking, hypercholesterolemia, and hypertension.

Number of risk factors*

MRFIT. Diabetes Care 1993

0

20

40

60

80

100

120

140

None One only Two only All three

612

22

47

31

59

91

125ΜΗ διαβητικοί (n=342,815)

ΔΙΑΒΗΤΙΚΟΙ (n=5,163)

Diabetes (EU prevalence 6.5% vs Cyprus 9.3%)

IDF Diabetes Atlas 2018

• 451 million (2017) → 693 million(2045)

• Half of diabetics are undiagnosed

• +374 million people with impaired glucose tolerance (IGT)

• Approximately 5 million deaths worldwide were attributable to

diabetes (2017)

• Global healthcare expenditure USD 850 billion (2017)


Obesity: Age-standardized mean BMI (kg/m2), 18+ years, 1980–2014, ESC member countries


Overweight / Obesity

• Increasing BMI

& prevalence

• > 1/5 adults

(CY: >1/4)

• > 1/8 girls

• > 1/6 boys


2 στους 5 θανάτους στην Κυπρο

μπορουν να αποδοθουν σε

συμπεριφορικους παράγοντες κινδυνου

State of Health in the EU: Cyprus. OECD 2019

Smoking

• Reduced prevalence,

mainly in men


Smoking

• EU 28%

• CY 39.2% /

14.3% (2008)



Total energy consumption Fat consumption

Vegetable consumption Fruit consumption

Diet

Δίαιτα

Dauchet et al. J Nutr 2007

Sofi et al. BMJ 2008

Μείωση των στεφανιαίων

επεισοδίων κατά 7% ανά μερίδα

φρούτου/λαχανικού ανά ημέρα

Η μεσογειακή δίαιτα μειώνει κατά

9% τον CV κίνδυνο

Physical Activity

Walking MET-h/w)

Boone Heinonen et al. Obes Rev 2009

30 – 40% μείωση

του κινδύνου για ΣΝ

Άσκηση

Παράγοντας

κινδύνουΑπώλεια βάρους Φυσική δραστηριότητα

Υπέρταση ↓↓↓ ↓↓↓

Διαβήτης τ2 ↓↓↓ ↓↓

Χοληστερόλη Σαφής βελτίωση Σαφής βελτίωση

Στεφανιαία νόσος ↓↓ ↓↓↓

Εγκεφαλικό ↓ ↓↓

Άπνοιες στον ύπνο ↓↓ Άγνωστο

Νοητική λειτουργία Πιθανή βελτίωση Πιθανή βελτίωση

Manson et al. Arch Intern Med 2004


Physical Activity

Prevalence of insufficiently

active adults

ESC: 22.7% / 30.1% (M/F)

CY: 29.3% / 41.5% (M/F)

Definition: % of defined population

attaining less than 150 min of

moderate-intensity physical activity

per week or less than 75 min of

vigorous-intensity physical activity

per week (based on self-reported

physical activity captured using the

GPAQ).

Ψυχοκοινωνικοί παράγοντες.Στρες, κατάθλιψη και κίνδυνος ΟΕΜ

INTERHEART. Lancet 2005

Age-standardised prevalence of CVD per 100 000

in Cyprus (1990 – 2015)

0

1000

2000

3000

4000

5000

6000

7000

1990 2000 2010 2015

Male Female


Incidence of CVD in Cyprus (1990 – 2015)

0

500

1000

1500

2000

2500

3000

3500

1990 2000 2010 2015

Male Female


CVD Mortality Forecast to 2040

Foreman et al. Lancet 2018

Key messages

HealThink©2019

• CVD remain the main cause of death despite of the progress

• Known RF account for more than 90% of observed CVD

• The most important way to prevent CVD is to promote a healthy lifestyle throughout life

• Assess and manage all RF

• Key interventions:➢Education campaingns focusing on lifestyle and behavior change

early in life

➢Assess and manage effectively all RF

➢Emergency services and technical capacity for acute and chronicCVD

➢Universal health coverage

Thank you!

Trends in cardiovascular risk factors · Trends in cardiovascular risk factors Panos Stafylas, MD,...

Documents

Transcript of Trends in cardiovascular risk factors · Trends in cardiovascular risk factors Panos Stafylas, MD,...