Exposure Characteristics of Risk Factors in a Community-Based Middle-Aged and Elderly Population at High Risk of Cardiovascular Diseases

Abstract OBJECTIVE To assess the current situation of risk factor exposure and control among middle-aged and elderly people at high risk of atherosclerotic cardiovascular disease (ASCVD) in the community and provide a basis for optimizing prevention and control strategies. METHODS A cross-sectional survey was conducted. The middle-aged and elderly people (aged 40 years and above) with a confirmed diagnosis of ASCVD or a China-PAR (Prediction for ASCVD Risk in China) score of high-risk in Jinshui District, Zhengzhou City, were enrolled. The exposure and control of risk factors for cardiovascular diseases were analyzed. RESULTS A total of 4,357 residents at high risk of cardiovascular disease were enrolled, and the top three cardiovascular risk factors were hypertension (75.44%, 3,287 cases), diabetes mellitus (49.00%, 2,135 cases), and hyperlipidemia (47.05%, 2,050 cases). The prevalence of the “three highs” was higher in women. The treatment rates of patients with hypertension, diabetes mellitus, and hyperlipidemia were 59.96% (1,971/3,287), 51.48% (1,099/2,135), and 40.39% (828/2,050), respectively, and the control rates were 59.23% (1,947/3,287), 42.81% (1,947/3,287), and 24.15% (533/2,050), respectively. Risk factor aggregation was significant (60.45% for ≥2 risk factors). Among diabetic patients, those with “three highs” had the lowest control rate. Among patients with hyperlipidemia, with the increase of comorbidities, the lipid-lowering treatment rate increased, while the control rate decreased. Compared with ASCVD residents, among those with a high-risk China-PAR score, the antihypertensive treatment rate of hypertensive patients was lower (55.02% vs. 73.18%, χ2 = 88.789, P < 0.001), the anti-diabetic treatment rate of diabetic patients was lower (48.12% vs. 62.78%, χ2 = 31.873, P < 0.001), and the lipid-lowering treatment rate of patients with hyperlipidemia was lower (36.35% vs. 50.97%, χ2 = 35.833, P < 0.001), while the lipid control rate of patients with hyperlipidemia was higher (28.79% vs. 11.99%, χ2 = 21.218, P < 0.001). CONCLUSIONS The high-risk population of cardiovascular diseases in the community shows the characteristics of “two highs and two lows” (high prevalence of cardiovascular risk factors and aggregation of multiple risk factors; low treatment rate and low control rate), and there are gender and population differences in risk factor exposure and control, so it is urgent to optimize the comprehensive management of cardiovascular risk factors in the community, and implement precise prevention and control for different populations. There is an urgent need to further optimize the comprehensive management of cardiovascular risk factors in the community and to implement precise prevention and control for different populations.