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Overview of Cardiovascular Prevention: Risk Assessment

Risk Factors and Prevention

France: Cardiovascular Prevention at the workplace

By Marie-Christine Iliou, National CVD Prevention Coordinator for France (2018) 

Aim

  • To raise public awareness of cardiovascular prevention by promoting coherent and comprehensive healthy lifestyle, tobacco cessation and nutritional education at the workplace.

Target Group

  •  Adults

Method

  • Initiative of two associations: The "French Federation of Cardiology" together with the "Heart and Work" association
  • Organisation of a "heart-day" at work (upon request of the company via the occupational doctors or workers); the interventions are paid by companies
  • Activities include:
    • conferences held by cardiologists (ie: about the global risk, cv risks factors, exercise, nutrition, psychosocial stress…)
    • screening and/or workshops by nurses or students: questionnaires, stress assessments, blood pressure, measures of BMI, and sometimes blood glucose and/or cholesterol assessments

Main results

  • 10 campaigns per year: the participation rate in general is > 25 % of the employees with a high degree of satisfaction of the participants.

As one example in the publicity media group:

  • 183 questionnaires were filled in with the results:
    • 54 % < 40 years
    • 70 % of women
    • 34 % with a family history of CVD
    • 32 % of smoking
    • 60 % declare > 30 min of physical activity 
  • Measurements
    • 18 % with BP > 140/90
    • BMI > 25 in 26 %
    • 16 % had fasting blood glucose > 1.40 g
    • Participants with abnormal results received personalised advice to consult their doctor.

These results stimulated discussions about modifying the menu of the work canteens and organising physical activities at the work place.

More information

Visit the websites:

Read the "Country of the Month" report from France to get more detailed information about CVD Prevention in this country.  

Norway: “The NOCAR project”

(The NOCAR project: The Norwegian Collaboration on Atherosclerosis in patients with Rheumatic joint diseases)

By Anne Grete Semb, Consultant Cardiologist and Senior Researcher

Aim

Patients with inflammatory joint diseases (IJD) have an increased risk of cardiovascular disease (CVD) and are undertreated regarding CVD prevention. Our goal was to design a structured program for CVD risk assessments to be implemented into routine rheumatology outpatient clinic visits.

Target Group

Patients with inflammatory joint diseases (IJD).

Method

For calculation of the patient’s risk of CVD by SCORE, lipids were added to the routine laboratory tests. Self-reporting of CVD risk factors and blood pressure measurements at the time of the clinical joint examination were done. The CVD risk was automatically calculated in the electronic patient journal.

Patients with increased CVD risk were referred by the rheumatologist to their primary care physician for initiation of CVD preventive measures.

Main results

NOCAR started April 2014 including 11 out of 15 Norwegian rheumatology clinics and lifted the offer of CVD risk evaluation for 48 % of the patients in this high risk patient population, for whom such evaluations were not previously offered.

In this Norwegian nationwide project we have shown that CVD risk assessment is feasible as a part of a daily rheumatology practice.

More information

For more information visit the NOCAR website

References:

1. Wibetoe G, Ikdahl E, Rollefstad S, Olsen IC, Bergsmark K, Kvien TK, Salberg A, Soldal DM, Bakland G, Lexberg Å, Fevang BT, Gulseth HC, Haugeberg G, Semb AG. Cardiovascular disease risk profiles in inflammatory joint disease entities. Arthritis Res Ther. 2017 Jul 3;19(1):153. PMID: 28673314

2. Wibetoe G, Ikdahl E, Rollefstad S, Olsen IC, Bergsmark K, Kvien TK, Salberg A, Soldal DM, Bakland G, Lexberg Å, Fevang BT, Gulseth HC, Haugeberg G, Semb AG. Discrepancies in risk age and relative risk estimations of cardiovascular disease in patients with inflammatory joint diseases. Int J Cardiol. 2018 Feb 1;252:201-206. PMID: 29249429

Read the "Country of the Month" report from Norway to get more detailed information about CVD Prevention in this country.

 

Turkey: “Healthy Cities” movement

by Dilek Ural, National CVD Prevention Coordinator for Turkey (2018)

Aim

Engaging local governments in promoting health to their citizens through a process of political commitment, institutional change, capacity-building, partnership-based planning and innovative projects.

Target Group

Urbanized population

Method

Each year, member municipalities apply to Healthy Cities Best Practice Awards contest with their projects. The awardees of Turkish Healthy Cities Association in ‘Healthy Life Category’ of this year are as follows:

  • Izmir - “European Bicycle Contest” project: Izmir is the first city to initiate the Bicycle Master Plan in Turkey. With new cycle roads and the bicycle-sharing system that the Metropolitan Municipality brought into the city, bicycle use in Izmir increased significantly. The city participated in the European Cycling Challenge where the cities competed counting "cycling kilometers" and the most cycled city win. Izmir's new goal is to enter the European Cycle Route Network “EuroVelo” which is a a sustainable alternative tourism model supported by the European Parliament's Committee on Transport and Tourism.  EuroVelo 8 Mediterranean Route starts from Spain, and connects 11 countries including France, Monaco, Italy, Slovenia, Croatia, Bosnia-Herzegovina, Montenegro, Albania, Greece and Cyprus. Izmir aims to participate into this network.
  • Jury’s special award was given to Kahramanmaraş Metropolitan Municipality for their “Smart Elderly Care and Coordination Center” project. The project aims to support elderly at home by informing the relevant healthcare authorities on essential medical conditions during their daily life and tracking their health status remotely by the call center personnel especially in the elderly people living alone. Especially the elderly living alone will be protected by establishing a system that will notify the emergency service, ambulance, police and fire departments in case of fire, gas poisoning, smoke, water overflow etc. Measures of blood pressure, heart rate and heart rate of elderly people will be provided by many intelligent systems such as systems to be installed in homes of elderly people, emergency buttons, smart medicine usage boxes and will be rapidly delivered to the authorities through the system from the call center screen in case of medical necessity. In situations such as an elderly person falling in the house, a vibration-sensitive waist unit will immediately signal to the call center and the call center will be able to direct support teams there.

Main results

The main results of these projects will be available in 2019.

For the projects reported last year, we don’t have definite results because most of them were short-term campaigns.

The project “carbon footprint” is going on, the municipalities launched their strategic plans and the results will be available in the forthcoming years.

More information

For more information visit this website.

Read the "Country of the Month" report from Turkey to get more detailed information about CVD Prevention in this country.

 

Note: The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.