Original Article
Stratified management for cardiovascular diseases risk in community population based on China-PAR
Bai Xue, Nie Ying, Luo Shihuan, Zhang Xinhuan, Xia Ronghui, Sun Yahui, Lu Yuntao
Published 2023-03-04
Cite as Chin J Gen Pract, 2023, 22(3): 271-277. DOI: 10.3760/cma.j.cn114798-20220701-00716
Abstract
ObjectiveTo evaluate the effect of stratified management of cardiovascular diseases risk in community population based on China-PAR.
MethodsIt was a single arm study. Beijing Jiaotong University faculty and staff who participated in annual health check-up from 2019 to 2021 and met the inclusion/exclusion criteria were enrolled in the study. The general data, physical examination and laboratory test results, including age, residence region, waist circumference, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C),blood pressure (BP), taking antihypertensive drugs,diabetes, family history of cardiovascular diseases,were collected. Participants were stratified according to China-PAR assessment model and then stratified management was carried out. For low-risk populations, family doctors provided online guidance or outpatient follow-up if necessary after their first interview. For middle and high-risk groups, outpatient and telephone follow-up were arranged in addition to online guidance. Relevant examinations were completed and drug treatment or adjustment were given by doctors when necessary. Frequency of outpatient follow-up for middle and high-risk groups was different and patients in these two groups were scored again at the end of 2-year follow-up.
ResultsA total 284 participants were enrolled,197 participants (69.4%) were males with a age of (46.9±8.8) years. Among them, 205 participants (72.2%) were in low-risk group, including 136 males (66.3%), and their 10-year risk of cardiovascular diseases was (2.5±0.1)%; 59 participants (20.8%) were in middle-risk group, including 43 males (72.9%), and their 10-year risk of cardiovascular diseases was (7.1±0.2)%;20 participants (7.0%) were in high-risk group,including 18 males (90.0%) and their 10-year risk of cardiovascular diseases was (14.0±1.1)%. After 2 years follow-up, the proportion of dietary imbalances and alcohol drinking, waist circumference, blood pressure, fasting glucose levels and risk score decreased significantly in high risk group (P<0.05). The proportion of dietary imbalances, waist circumference, blood pressure, total cholesterol, and LDL-C levels decreased significantly in medium risk group (P<0.05). In high-risk group, 2 participants (10.0%) converted to low-risk, 8 participants (40.0%) converted to middle-risk. In middle-risk group, 5 participants (8.5%) converted to low-risk and 7 participants (11.9%) converted to high-risk.
ConclusionThe risk factors and risk stratification of cardiovascular disease in community population can be improved by stratified management based on China-PAR risk assessment model.
Key words:
Cardiovascular diseases; Risk assessment; Primary prevention
Contributor Information
Bai Xue
Beijing Jiaotong University Community Health Service Center, Beijing 100044, China
Nie Ying
Beijing Jiaotong University Community Health Service Center, Beijing 100044, China
Luo Shihuan
Beijing Jiaotong University Community Health Service Center, Beijing 100044, China
Zhang Xinhuan
Beijing Jiaotong University Community Health Service Center, Beijing 100044, China
Xia Ronghui
Beijing Jiaotong University Community Health Service Center, Beijing 100044, China
Sun Yahui
Beijing Jiaotong University Community Health Service Center, Beijing 100044, China
Lu Yuntao
Beijing Jiaotong University Community Health Service Center, Beijing 100044, China