An Evolving Pattern of Cardiovascular Risk in 14,315 Men and Women Attending A Nurse-Led, Cardiac Profiling and Prevention Clinic over a Quarter of a Century

Abstract

Purpose: We examined the risk profile of >14,000 first time attendees to a nurse-led, cardiac profiling and prevention clinic over a 25-year period. Methods: Routine demographic and clinical data were collected in a standardised manner in 7815 men and 6500 women who visited the clinic from 1986 to 2011. Data were compared on a sex-specific basis during five periods (1986–1991 [P1], 1992–1996 [P2], 1997–2001 [P3], 2002–2006 [P4], 2007–2011 [P5]). Results: Overall, the age of men (45.2 ± 14.9 years vs. 53.2 ± 14.6 years) and women (45.8 ± 15.5 years vs. 52.4 ± 14.3 years) was similar older over time (P1–P5). In men, average blood pressure (BP) peaked in P3 (135 ± 18/84 ± 11 mmHg vs. 131 ± 16/83 ± 10 mmHg in P1) before declining in P4/P5 and in women peaked during P4 (137 ± 21/80 ± 11 mmHg vs. 126 ± 19/79 ± 11 mmHg in P1); p < 0.001. Men and women with elevated BP (≥140/90 mmHg) peaked in P2 (46.6%) and in P4 (45%), respectively, but declined overall (39.5–31.7% and 28.2–24% for P1/P5, respectively); p < 0.001. In men only there was an overall fall in total cholesterol (5.4 ± 1.1 mmol/L vs. 5.0 ± 1.2 mmol/L, P1–P5; p < 0.001). Men and women with elevated lipid levels generally declined over time (41.8–30.8% and 40.3–32.1%, P1/P5, respectively); p < 0.001. Proportions of male smokers initially declined (14.3–11.2% in P3) before rising again (14.4% in P5) and in women progressively declined (13.3–10.4%, P1/P5; p < 0.001). Throughout the study period (P1–P5) both men (79.1 ± 11.8 kg vs. 84.7 ± 15.7 kg) and women (63.6 ± 11.1 kg vs. 70.7 ± 15.6 kg) became heavier; p < 0.001. Conclusions: The risk profile of men and women presenting to a nurse-led CVD prevention clinic has changed over time with attendees becoming older and heavier.