Abstract 59: Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Diseases Among Vulnerable Population of a Safety Net Hospital

Abstract

Cardiovascular disease (CVD) is the leading cause of death and remains a major cause of health disparities. The underuse of prevention strategies and suboptimal control of risk factors could partially explain the increased CVD burden. We conducted a study to assess the prevalence of major cardiovascular risk factors and cardiovascular disease among vulnerable population in a general medical clinic (GMC) of a safety net hospital. A retrospective chart review of patients was conducted in GMC at John Stroger Hospital. Patients were selected using a random sampling method over two weeks and demographic, clinical and laboratory data was collected. Major CVD risk factors were defined based on current national guidelines. Hypercholesterolemia and dyslipidemia were defined as total cholesterol ≥240mg/dl, or LDL ≥160mg/dl, or HDL <40mg/dl (for persons with and without diabetes) or receiving cholesterol-lowering medication. Hypertension was a blood pressure (BP) ≥140/90 mmHg, or receiving antihypertensive medication. Obesity was defined as a BMI of 30 or greater. Diabetes mellitus was a fasting plasma glucose ≥126mg/dl, 2-hour-postload plasma glucose ≥200mg/dl, an HgbA1c ≥6.5%, or use of antihyperglycemic medications. Smoking was defined as currently smoking cigarettes. Prevalence of CHD and stroke was ascertained based upon the physician’s problem list. Of 255 charts, 5 were excluded from analysis because of missing data. The mean age was 61; 57% were women, 59% were African American. The overall prevalence of hypercholesterolemia was 57 % among men (62 of 108) and 56% (80 of 142) among women; with the highest among African American. Overall, 92 out of 108 (85%) of men and 116 out of 142 (82%) of women had hypertension; prevalence was respectively 60% (55 of 92) and 68% (79 of 116) for African American men and women. About 48 out of 108 (44%) of men were obese and among women overall prevalence of obesity was 52% (74 of 142). Overall, 50 out of 108 (49%) of men and 73 out of 142 (51%) of women had diabetes. The overall prevalence of smoking was 11% (27 of 250) and ranged from 10% (14 of 142) among women to 12% (13 of 108) among men. Overall, 10% (11 of 108) of men had an adverse level of any 1 major risk factor only; 26% (28 of 108) and 59% (64 of 108) had any 2 only or 3 or more risk factors. Among women, 16% (23 of 142) had 1 risk factor only; 25% (36 of 142) and 54% (76 of 142) had 2 or 3 or more risk factors. The overall prevalence of CHD and stroke was, respectively, 18% (19 of 108) and 1% (1 of 108) for men and 9% (13 of 142) and 10% (14 of 142) for women. In conclusion, findings from the study demonstrate the pervasive burden of CVD risk factors in vulnerable groups compared with the national trends. These data may enhance the impetus to implement interventions to lower burden of CVD risk factors among overall and targeted at-risk groups, as well as develop strategies to prevent future development of adverse CVD risk factors starting at the youngest age.