Preventing Chronic Disease | Screening for Cardiovascular Risk in Asymptomatic Users of the Primary Health Care Network in Lebanon, 2012–2013 - CDC
Screening for Cardiovascular Risk in Asymptomatic Users of the Primary Health Care Network in Lebanon, 2012–2013
Rouham Yamout, MD, MPH; Salim M. Adib, MD, DrPH; Randa Hamadeh, MPH; Alia Freidi, PharmD, MPH; Walid Ammar, MD, PhD
Suggested citation for this article: Yamout R, Adib SM, Hamadeh R, Freidi A, Ammar W. Screening for Cardiovascular Risk in Asymptomatic Users of the Primary Health Care Network in Lebanon, 2012–2013. Prev Chronic Dis 2014;11:140089. DOI:http://dx.doi.org/10.5888/pcd11.140089
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.PEER REVIEWED
Abstract
Introduction
In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population.
In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population.
Methods
A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension.
A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension.
Results
Approximately 25% of the sample displayed metabolic impairments (11% for impaired blood glucose metabolism and 17% for impaired systolic blood pressure), and 6.6% were classified at total cardiovascular risk of 10% or more. Just over one-quarter of the sample was obese, almost half had a substantially elevated waist circumference, and 41% were smokers. Men were significantly more likely to screen positive for metabolic impairment than women, and women were more likely to be obese.
Approximately 25% of the sample displayed metabolic impairments (11% for impaired blood glucose metabolism and 17% for impaired systolic blood pressure), and 6.6% were classified at total cardiovascular risk of 10% or more. Just over one-quarter of the sample was obese, almost half had a substantially elevated waist circumference, and 41% were smokers. Men were significantly more likely to screen positive for metabolic impairment than women, and women were more likely to be obese.
Conclusion
The implementation of a multifactorial screening for CVD among asymptomatic subjects detected a substantial proportion of previously undiagnosed cases of high metabolic risk, people who could now be referred to optimal medical follow-up.
The implementation of a multifactorial screening for CVD among asymptomatic subjects detected a substantial proportion of previously undiagnosed cases of high metabolic risk, people who could now be referred to optimal medical follow-up.
Acknowledgments
The pilot phase was supported technically and financially by the WHO country office in Beirut, Lebanon. The authors thank the following colleagues for their input during the design and the implementation of this project: Dr Mohamad Sandid (Director of the National Diabetes Program), Mr Ali Roumani (MOPH Information Technology Manager), and the staff of the MOPH Primary Health Care Department: Ramia Assad, Zeinab Berry, Rabha Charafeddine, Safa Hajj Suleiman, Jaafar Jabak, Wafaa Kanaan, Faten Moustafa, and Fadi Wehbe. The authors also thank Drs Samer Jabbour, Mohamad Samir Arnaout, and Ghassan Hamadeh.
Author Information
Corresponding Author: Rouham Yamout, MD, MPH, Centre for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon. Telephone: 011-961-374-7031. E-mail: rouham@gmail.com.
Author Affiliations: Salim M. Adib, Faculty of Public Health, Lebanese University, Beirut, Lebanon; Randa Hamadeh, Ministry of Public Health, Beirut, Lebanon; Alia Freidi, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon; Walid Ammar, Faculty of Health Sciences, American University of Beirut, and Ministry of Public Health, Beirut, Lebanon.
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