The occurrence of cardiovascular risk factors and functioning in chronic illness in the Polish population of EUROASPIRE V

Abstract

Background: The aim of this study was to assess the impact of cardiovascular risk on the functioning of patients without a history of atherosclerotic cardiovascular disease.

Methods: Two hundred patients diagnosed with arterial hypertension, hypercholesterolemia, or diabetes were enrolled in the study. The median age was 52.0 years (interquartile range [IQR] 43.0-60.0). The following risk factors were assessed: blood pressure, body mass index, waist circumference, physical activity, smoking, LDL-cholesterol, triglycerides, and fasting plasma glucose concentration. Total cardiovascular risk was determined as the number of uncontrolled risk factors, and with the Systemic Coronary Risk Evaluation Score (SCORE). The Functioning in the Chronic Illness Scale (FCIS) was applied to assess the physical and mental functioning of patients.

Results: The median number of measures of cardiovascular risk factors was 4.0 (IQR 3.0-5.0). The median of SCORE for the whole study population was 2.0 (IQR 1.0-3.0). Patients with lower total cardiovascular risk as defined by SCORE and number of uncontrolled risk factors had better functioning as reflected by higher FCIS (R = -0.315, p < 0.0001; R = -0.336, p < 0.0001, respectively). Multivariate logistic regression analysis identified abnormal blood pressure, abnormal waist circumference, tobacco smoking, and lack of regular physical activity to be negative predictors of functioning. Lack of regular physical activity was the only predictor of low FCIS total score (odds ratio 9.26, 95% confidence interval 1.19-71.77, p = 0.03).

Conclusions: The functioning of patients worsens as the total cardiovascular risk increases. Each of the risk factors affects the functioning of subjects without coronary artery disease with different strength, with physical activity being the strongest determinant of patient functioning.

Keywords: cardiovascular risk factors; functioning of patients.

Figure 1

Functioning of patients in relation to cardiovascular risk stratified according to the SCORE and the number of uncontrolled risk factors; A. Functioning of patients according to the FCIS (subscales and total score) in a subset of patients with increasing total cardiovascular risk assessed with the SCORE (1A), expressed as the number of uncontrolled risk factors (2A); B. Spearman correlation between FCIS total score and the SCORE (1B), and the number of uncontrolled risk factors (2B); C. Discrimination of FCIS score threshold indicating patients with high or very high cardiovascular risk according to the SCORE (1C) and to the number of uncontrolled risk factors (2C)

Figure 2

Impact of single risk factors on the occurrence of high FCIS total score. Univariate regression analysis; OR — odds ratio; CI — confidence interval; LDL-C — low-density lipoprotein cholesterol; TG — triglycerides; BMI — body mass index