A Cross-Sectional Survey of Cardiometabolic Risk Factors in Canadian Primary Care Patients with Abdominal Obesity

Abstract

The objectives of this cross-sectional study were to evaluate the prevalence as well as the management of cardiometabolic risk factors (CMRFs) in overweight/obese Canadians. Subjects with increased body mass index (BMI >27 kg/m2 )/waist circumference (WC >94 cm in men, >80 cm in women) were recruited by 468 primary care physicians across Canada (37% from Ontario, 28% from Quebec and 35% from other provinces), and evaluated during a single clinic visit. In addition, the following risk factors were also assessed: hypertension (SBP >130 and/or DBP >80), dysglycemia (IGT or diabetes), low HDL-C (<1 in men or <1.3 mmol/L in women), triglycerides >1.7 mmol/L, LDL-C >3.5 mmol/L or >2 with cardiovascular event, and smoking status. A total of 9985 subjects were included in the analysis: mean age 58 years, M/F (52%/48%), mean BMI 33.2 and 34.0 kg/m2, mean WC 113.2 cm and 106.4 cm, for men and women, respectively. Women had a median of ≥3 CMRFs while men had a median of ≥4 CMRFs. 70% of the subjects had additional CMRFs with the following prevalence: high LDL-C (81.9%), hypertriglyceridemia (69.8%), hypertension (67.2%), low HDL-C (51.6%), high LDL-C + hypertension (63.4%), high LDL-C + low HDL-C (45.7%), hypertension + low HDL-C (37.3%), low HDL-C + high LDL-C + hypertension (36.2%), diabetes (34%), high LDL-C + dysglycemia (33.0%). Guideline targets for prediabetes, diabetes, dyslipidemia and hypertension were often not being achieved despite treatment. CMRFs are more common in overweight/obese people with abdominal obesity in primary care, and require more intensive surveillance and management to reduce their cardiometabolic risk.