Trends in Cardiovascular Disease Risk Factor Prevalence and Estimated 10-Year Cardiovascular Risk Scores in a Large Untreated French Urban Population: The CARVAR 92 Study

Background
Surveys measuring effectiveness of public awareness campaigns in reducing cardiovascular disease (CVD) incidence have yielded equivocal findings. The aim of this study was to describe cardiovascular risk factors (CVRFs) changes over the years in an untreated population-based study.
Methods
Between 2007 and 2012, we conducted a screening campaign for CVRFs in men aged 40 to 65 yrs and women aged 50 to 70 yrs in the western suburbs of Paris. Data were complete for 20,324 participants of which 14,709 were untreated.
Results
The prevalence trend over six years was statistically significant for hypertension in men from 25.9% in 2007 to 21.1% in 2012 (p=0.002) and from 23% in 2007 to 12.7% in 2012 in women (p<0.0001). The prevalence trend of tobacco smoking decreased from 38.6% to 27.7% in men (p=0.0001) and from 22.6% to 16.8% in women (p=0.113). The Framingham 10-year risk for CVD decreased from 13.3 ± 8.2 % in 2007 to 11.7 ± 9.0 % in 2012 in men and from 8.0 ± 4.1 % to 5.9 ± 3.4 % in women. The 10-year risk of fatal CVD based on the European Systematic COronary Risk Evaluation (SCORE) decreased in men and in women (p <0.0001).
Conclusions
Over a 6-year period, several CVRFs have decreased in our screening campaign, leading to decrease in the 10-year risk for CVD and the 10-year risk of fatal CVD. Cardiologists should recognize the importance of community prevention programs and communication policies, particularly tobacco control and healthier diets to decrease the CVRFs in the general population.

研究背景
评估公众认知宣传项目降低心血管疾病（Cardiovascular Disease, CVD）发病率效果的相关调查，所得结论始终莫衷一是。本研究旨在基于一项未接受治疗的人群队列研究，阐述数年间心血管危险因素（Cardiovascular Risk Factors, CVRFs）的变化情况。

研究方法
2007年至2012年间，我们在巴黎西郊针对40至65岁男性、50至70岁女性开展了心血管危险因素筛查项目。最终纳入20324名资料完整的参与者，其中14709名未接受过相关治疗。

研究结果
六年随访期间，男性高血压患病率从2007年的25.9%降至2012年的21.1%（p=0.002），女性则从2007年的23%降至2012年的12.7%（p<0.0001），上述趋势均具有统计学显著性。男性吸烟率从38.6%降至27.7%（p=0.0001），女性从22.6%降至16.8%（p=0.113）。男性弗雷明汉10年心血管疾病发病风险从2007年的13.3±8.2%降至2012年的11.7±9.0%，女性则从8.0±4.1%降至5.9±3.4%。基于欧洲系统性冠状动脉风险评估（European Systematic COronary Risk Evaluation, SCORE）的10年致命性心血管疾病发病风险，在男性与女性群体中均有所下降（p<0.0001）。

研究结论
为期六年的筛查项目中，多项心血管危险因素的患病率均有所下降，进而使得10年心血管疾病发病风险与10年致命性心血管疾病发病风险均得以降低。心血管科医师应充分认识社区预防项目与传播政策的重要性，尤其应通过控烟与健康饮食等手段，降低普通人群的心血管危险因素水平。