perception of cvd risk factors by different...
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PERCEPTION OF CVD RISK FACTORS
BY DIFFERENT STAKEHOLDERS -
DOCTORS, MEDICAL STUDENTS,
GENERAL PUBLIC, POLITICIANS,
JOURNALISTS
Professor ŽeljkoReiner, MD,PhD,FRCP(Lond),FESC,FACC
University Hospital Center Zagreb,
University of Zagreb, Zagreb School of
Medicine, Croatia
CAUSES OF DEATH IN CROATIA IN 2008
Izvor podataka: Državni zavod za statistiku, Hrvatski zavod za javno zdravstvo
PERCRO Study - PERCEPTION OF CARDIOVASCULAR
RISK FACTORS IN CROATIA – GENERAL POPULATION
A questionnaire with 25 multiple choice
questions
In 37 pharmacies covering the whole area
of Croatia consecutively to all customers
willing to answer
883 respondents (questionnaires finished)
September 1 to November 30, 2007
PERCRO Study - PERCEPTION OF CARDIOVASCULAR
RISK FACTORS IN CROATIA – PHYSICIANS
In Croatia - 11 799 physicians (1753 GPs and 927
specialists in GP/family medicine, 987 general internists,
203 cardiologists)
randomly recruited using national physicians registry and
professional societies’ directories
5 regions, all cardiologists, every third GP/FP, every fifth
internist
A questionnaire with 25 multiple choice questions
1382 physicians (930 GP/FP, 165 cardiologists, 213
internists) answered
March 1 to June 30, 2008
PERCRO Study - PERCEPTION OF CARDIOVASCULAR
RISK FACTORS IN CROATIA – MEDICAL STUDENTS
A questionnaire with 25 multiple choice
questions
443 medical students at the beginning of the
study and at the end of the study
On the enrolment day and graduation day
September 2008
School of Medicine, University of Zagreb
PERCRO Study - PERCEPTION OF CARDIOVASCULAR
RISK FACTORS IN CROATIA – MEMBERS OF PARLIAMENT
77 out of 141 members of the Croatian
Parliament - Sabor
One day during the Parliament session in
the Houses of Parliament 2008
A questionnaire with 25 multiple choice
questions
PERCRO Study - PERCEPTION OF CARDIOVASCULAR
RISK FACTORS IN CROATIA – JOURNALISTS
A questionnaire with 25 multiple choice
questions
129 journalists from daily press –
newspaper, TV, radio
In the Croatian Press Association House
One day in 2008
Age Groups Distribution (years)
0%1,1%
5,4%
8,7%
22,8%
35,9%
23,9%
2,2%1,6%
16,3%
24,0%
27,1% 27,1%
3,9%
0% 0%0% 0%
6,8%
31,5%
28,8%
23,3%
9,6%
0%0%
7,9%
26,2%
46,9%
19,0%
0% 0% 0%
15-24 25-34 35-44 45-54 55-64 65-74 75-84 >85
General Pupolation
Journalists
Politicians
Doctors
Medical Students all belong to the 15-24 age group
Groups by Gender
47% 53%44% 56%
General Population Journalists
Medical Students
32,58%
67,42%
Male Female
40,28%59,72%
Politicians
Knowledge of Blood Pressure
26%
74%
Know Their Blood Pressure
Don't know/No Answer
General Population Journalists
13%
87%
82%
18%
Medical Students
90%
10%
Politicians
Knowledge of Cholesterol LevelsGeneral Population Journalists
43%57%42%
58%
Know Their Level
Don't Know Level/No Answer
74%
26%
Medical Students
79%
21%
Politicians
Awareness of “Bad” Cholesterol
10,9% 12,0%8,7%
14,1%
54,3%
14,7%
31,0%
20,2%
7,8%
26,4%
9,9%
83,5%
2,7% 2,0% 1,8%5,3%
56,8%
5,3% 5,3%
27,3%
HDL Cholesterol LDL Cholesterol Triglycerides None of
Mentioned
No Answer/Invalid
Answer
General Population
Journalists
Medical Students
Politicians
Awareness of “Good” Cholesterol
23,9%
9,8%
2,2%
14,1%
50,0%
45,0%
16,3%
3,1%
9,3%
26,4%
12,0%
0,9% 2,5% 2,3%
62,3%
5,2%
1,3%
5,2%
26,0%
82,4%
HDL Cholesterol LDL Cholesterol Triglycerides None of Mentioned No Answer/Invalid
Answer
Population
Journalists
Medical Students
Politicians
Fear of Listed Diseases
40,0%
14,5%
5,1%
21,6%
2,0%0,2%
16,5%
48,6%
18,6%
0%
9,3%
0% 0,8%
23,3%
63,9%
10,4%
13,5%
7,0%
2,3% 1,1% 1,8%
14,3%
42,9%
13,0%
0,0% 0,0% 1,3%
28,6%
Cancer Cerebrovascular
disease
AIDS Heart disease Liver disease Tuberculosis and
pulmonary
disease
No Answer/
Don'tknow
General Population
Journalists
Medical Students
Politicians
Awareness of the Leading Cause of
Death
16,4%
0,2%
0,3%
36,1%
0,8%
8,6%
27,0%
10,5%
17,8%
0,8%
0,0%
53,5%
0,0%
5,4%
16,3%
6,2%
0,2%
0,0%
0,2%
72,0%
0,2%
5,9%
10,6%
10,8%
17,7%
0,0%
0,0%
53,5%
0,0%
5,4%
16,3%
6,2%
Don't Know/No Answer
Tuberculosis/Pulmonary
Disease
Liver Cirrhosis
Heart Disease
AIDS
Cerebrovascular Disease
Cancer
Traffic Accidents Politicians
Medical Students
Journalists
Population
Total cholesterol
p=0,764
Kruskal-Wallis test
Triglycerides
Kruskal-Wallis test
p=0,767
HDL - cholesterol
Population : Parliament
p=0,540
Population : Journalists
p=0,003
Journalists : Parliament
p=0,003
Mann-Whitney test with correction for multiple testing
LDL - cholesterol
Mann-Whitney test with correction for multiple testing
Population : Parliament
p=0,999
Population : Journalists
p=0,027
Journalists : Parliament
p=0,045
hs-CRP
Population : Parliament
p=0,999
Population : Journalists
p=0,069
Journalists : Parliament
p=0,042
Mann-Whitney test with correction for multiple testing
Glucose
Population : Parliament
p=0,999
Population : Journalists
p=0,015
Journalists : Parliament
p=0,100
Mann-Whitney test with correction for multiple testing
HbA1c
Mann-Whitney test with correction for multiple testing
Population : Parliament
p=0,876
Population : Journalists
p=0,003
Journalists : Parliament
p=0,003
Height
Mann-Whitney test with correction for multiple testing
Population : Parliament
p=0,003
Population : Journalists
p=0,390
Journalists : Parliament
p=0,003
Weight
Mann-Whitney test with correction for multiple testing
Population : Parliament
p=0,003
Population : Journalists
p=0,999
Journalists : Parliament
p=0,003
BMI
Mann-Whitney test with correction for multiple testing
Population : Parliament
p=0,003
Population : Journalists
p=0,681
Journalists : Parliament
p=0,003
Waist
Mann-Whitney test with correction for multiple testing
Population : Parliament
p=0,003
Population : Journalists
p=0,999
Journalists : Parliament
p=0,003
Smoking Habits
28%
15%
57%
30%
18%
52%
22%
3%
75%
18%
3%
79%
Smoker Former smoker Non-smoker
General Population
Journalists
Medical Students
Politicians
GP informed about the CV risks
44,1%
42,6%
20,6%
14,7%
38,2%
30,9%
27,0%
22,0%
21,1%
52,8%
High Cholesterol Levels
High Blood Pressure
Smoking
Obesity/Overweight
None
Population Journalists
Doctors by Speciality
68,9%12,2%
18,8%3,0%
Family Doctors
Cardiologists
Internists
Neurologists
Following of CVD Prevention Guidelines
by Speciality
17,5%
1,4%
3,8%
59,1%
1,4%
16,7%
10,6%
2,8%
7,1%
59,6%
1,4%
18,4%
7,4%
0,9%
9,3%
71,3%
1,9%
9,3%
Own judgment
Institution guidelines
Joint European guidelines from 1998
Joint European guidelines from 2007
US Guidelines
International Atherosclerosis Society
guidelines
Cardiologists
Internists
Primary care
Guidelines’ usefulness
75,5%
22,9%
0,3%
1,2%
82,7%
15,4%
0,6%
1,2%
76,8%
20,9%
0,5%
1,8%
Very useful
Fairly useful
Not useful
Do not know
guidelines
Cardiologists
Internists
Primary care
Knowledge of Joint European guidelines
recommendation for HDL-chol. in women
3,9%
3,6%
21,0%
6,5%
58,7%
6,3%
0,5%
3,0%
17,4%
7,0%
69,7%
2,5%
5,7%
5,1%
23,6%
2,5%
59,2%
3,8%
< 0.9 mmol/l
> 0.9 mmol/l
> 1.0 mmol/l
< 1.0 mmol/l
> 1.2 mmol/l
< 1.2 mmol/l
Cardiologists
Internists
Primary care
Knowledge of Joint European CVD
Prevention Guidelines recommendation
for blood pressure in high risk patients
0,9%
8,9%
39,7%
50,5%
2,9%
14,1%
48,5%
34,5%
0,6%
17,8%
43,3%
38,2%
140/90 mmHg
150/90 mmHg
130/85 mmHg
120/80 mmHg
Cardiologists
Internists
Primary care
Knowledge on optimal blood pressure in
high risk patients
6,3%
15,7%
37,1%
40,0%
1,6%
11,2%
42,1%
45,2%
<150/90 <140/90 <130/85 <120/80
Medical Students
Doctors
Knowledge of recommended HDL-
cholesterol in women (mmol/l)
3,7%
14,7%
22,2%
13,5%
34,7%
11,2%
3,6% 3,9%
21,1%
5,9%
60,2%
5,3%
<0,9 >0,9 >1,0 <1,0 >1,2 <1,2
Medical Students
Doctors
Knowledge on recommended LDL-cholesterol
in patients with diabetes (mmol/l)
24,3%
20,5%
30,4%
24,8%
7,5%6,4%
30,0%
56,1%
<5 <4 <3 <2,5
Medical Students
Doctors
Lowering cholesterol with diet
11,9%
54,5%
26,7%
5,0%1,9%
18,9%
68,4%
9,7%
2,7%0,3%
2-3% 10-15% about 50% 50-70% up to 90%
Medical Student
Doctors
Smatrate li da dobro liječite svoje bolesnike hipelipidemijom
74
7
19
95
14
0
10
20
30
40
50
60
70
80
90
100
da ne ne znam
Bro
j ispita
nik
a (
%) Liječnici OM (N=556)
Kardiolozi (N=134)
Do you Believe you Treat Well Your Patients
with Hyperlipidemia?
Thank you!