The Differences in the Prevalence of Cardiovascular Disease, Its Risk Factors, and Achievement of Therapeutic Goals among Urban and Rural Primary Care Patients in Poland: Results from the LIPIDOGRAM 2015 Study.

Krzysztof Studziński,Ewa Wójtowicz,Thomas M Macdonald,Tomasz Tomasik,Adam Windak,Mirosław Mastej,Maciej Banach,Peter E Penson,Bryan Williams,Naveed Sattar,Dimitri P Mikhailidis,Kausik K Ray,Fadi J Charchar,Maciej Tomaszewski,George Howard,Peter P Tóth ,Alberico L Catapano ,Gregory Y H Lip ,Jacek Jerzy Jóźwiak

doi:10.3390/jcm10235656

Abstract

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs.

Highlights

Differences in healthcare access, utilisation, and health status between rural and urban populations are described in the medical literature [1,2]
The average age of women living in cities was 2 years older than those living in rural settings (p < 0.01)
We found no important differences in the prevalence of hypertension, diabetes mellitus (DM), dyslipidaemia, or Cardiovascular diseases (CVD) in urban and rural adult populations attending primary care in Poland

Summary

Introduction

Differences in healthcare access, utilisation, and health status between rural and urban populations are described in the medical literature [1,2]. Risk factors include elevated blood pressure (BP), dyslipidaemia, hyperglycaemia, obesity, and smoking. The prevalence of CVD and CV risk factors is high in Central and Eastern. In Poland, over 15% of the patients attending primary health practices are diagnosed with CVD, over 60% have hypertension (HTN), over 80% are dyslipidemic, and approximately 15% of patients are diagnosed with diabetes mellitus (DM) [5]. Differences in CVD prevalence and levels of CV risk factors between urban and rural regions have been confirmed all across Europe [6,7,8,9].

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