The burden of modifiable cardiovascular risk factors in the coronary care unit by age, ethnicity, and socioeconomic status--PREDICT CVD-9

Abstract

Aims: To investigate the burden of modifiable cardiovascular disease (CVD) risk factors in patients admitted to coronary care by age, ethnicity, and socioeconomic status.

Design and setting: Cross-sectional study of patients presenting to the Middlemore Hospital Coronary Care Unit with an acute CVD event from July 2004 to June 2006.

Methods: CVD risk factor data was electronically collected using Acute PREDICT. Socioeconomic status was estimated using the NZ Deprivation 2001 index (NZDep01).

Results: Of 973 patients 34% were <55 years and 10% were <45 years, 24.8% were women, and 44.6% lived in areas classified as most deprived. 61.5% were European/other, 13.0% NZ Maori, 15.2% Pacific, and 10.3% South Asian. Younger patients, regardless of ethnicity, were much more likely to be smokers, be obese, have elevated LDL and trigyceride, and low HDL levels. Maori and Pacific patients were more likely than European/other patients to smoke, have diabetes, obesity, elevated triglycerides, and low HDL. These ethnic differences persisted across the age range. Increasing deprivation was associated with more smoking, obesity, hypertriglyceridaemia and diabetes, with the excess of smoking and obesity being most pronounced in younger patients.

Conclusions: In patients presenting to coronary care, there is a high burden of adverse modifiable CVD risk factors, particularly in younger patients and among Maori and Pacific people from areas of high deprivation. These risk factors are a major and reversible contributor to future CVD risk in these groups, and an important target for secondary prevention programs.