Assessment of cardiovascular risk in Tunisia: applying the Framingham risk score to national survey data
ObjectiveThis paper aims to assess the socioeconomic determinants of a high 10 year cardiovascular risk in Tunisia.SettingWe used a national population based cross sectional survey conducted in 2005 in Tunisia comprising 7780 subjects. We applied the non-laboratory version of the Framingham equation...
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| Veröffentlicht in: | BMJ open 2016-11, Vol.6 (11), p.e009195-e009195 |
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| creator | Saidi, O Malouche, D O'Flaherty, M Ben Mansour, N A Skhiri, H Ben Romdhane, H Bezdah, L |
| description | ObjectiveThis paper aims to assess the socioeconomic determinants of a high 10 year cardiovascular risk in Tunisia.SettingWe used a national population based cross sectional survey conducted in 2005 in Tunisia comprising 7780 subjects. We applied the non-laboratory version of the Framingham equation to estimate the 10 year cardiovascular risk.Participants8007 participants, aged 35–74 years, were included in the sample but effective exclusion of individuals with cardiovascular diseases and cancer resulted in 7780 subjects (3326 men and 4454 women) included in the analysis.ResultsMean age was 48.7 years. Women accounted for 50.5% of participants. According to the Framingham equation, 18.1% (17.25–18.9%) of the study population had a high risk (≥20% within 10 years). The gender difference was striking and statistically significant: 27.2% (25.7–28.7%) of men had a high risk, threefold higher than women (9.7%; 8.8–10.5%). A higher 10 year global cardiovascular risk was associated with social disadvantage in men and women; thus illiterate and divorced individuals, and adults without a professional activity had a significantly higher risk of developing a cardiovascular event in 10 years. Illiterate men were at higher risk than those with secondary and higher education (OR=7.01; 5.49 to 9.14). The risk in illiterate women was more elevated (OR=13.57; 7.58 to 24.31). Those living in an urban area had a higher risk (OR=1.45 (1.19 to 1.76) in men and OR=1.71 (1.35 to 2.18) in women).ConclusionsThe 10 year global cardiovascular risk in the Tunisian population is already substantially high, affecting almost a third of men and 1 in 10 women, and concentrated in those more socially disadvantaged. |
| doi_str_mv | 10.1136/bmjopen-2015-009195 |
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We applied the non-laboratory version of the Framingham equation to estimate the 10 year cardiovascular risk.Participants8007 participants, aged 35–74 years, were included in the sample but effective exclusion of individuals with cardiovascular diseases and cancer resulted in 7780 subjects (3326 men and 4454 women) included in the analysis.ResultsMean age was 48.7 years. Women accounted for 50.5% of participants. According to the Framingham equation, 18.1% (17.25–18.9%) of the study population had a high risk (≥20% within 10 years). The gender difference was striking and statistically significant: 27.2% (25.7–28.7%) of men had a high risk, threefold higher than women (9.7%; 8.8–10.5%). A higher 10 year global cardiovascular risk was associated with social disadvantage in men and women; thus illiterate and divorced individuals, and adults without a professional activity had a significantly higher risk of developing a cardiovascular event in 10 years. Illiterate men were at higher risk than those with secondary and higher education (OR=7.01; 5.49 to 9.14). The risk in illiterate women was more elevated (OR=13.57; 7.58 to 24.31). Those living in an urban area had a higher risk (OR=1.45 (1.19 to 1.76) in men and OR=1.71 (1.35 to 2.18) in women).ConclusionsThe 10 year global cardiovascular risk in the Tunisian population is already substantially high, affecting almost a third of men and 1 in 10 women, and concentrated in those more socially disadvantaged.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2015-009195</identifier><identifier>PMID: 27903556</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Aged ; Body Mass Index ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - prevention & control ; Cardiovascular Medicine ; Cross-Sectional Studies ; Educational Status ; Female ; Health Knowledge, Attitudes, Practice ; Households ; Humans ; Male ; Middle Aged ; Obesity, Abdominal - complications ; Obesity, Abdominal - epidemiology ; Population Surveillance ; Prevalence ; Risk Assessment ; Sex Factors ; Smoking - adverse effects ; Smoking - epidemiology ; Social Class ; Socioeconomic Factors ; Tunisia - epidemiology ; Womens health</subject><ispartof>BMJ open, 2016-11, Vol.6 (11), p.e009195-e009195</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-e5bda903ac9bfa1c580c5c1f20f89554498834474e9ad5b9b45c204f9b93453d3</citedby><cites>FETCH-LOGICAL-b472t-e5bda903ac9bfa1c580c5c1f20f89554498834474e9ad5b9b45c204f9b93453d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/6/11/e009195.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/6/11/e009195.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27528,27529,27903,27904,53770,53772,77348,77379</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27903556$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saidi, O</creatorcontrib><creatorcontrib>Malouche, D</creatorcontrib><creatorcontrib>O'Flaherty, M</creatorcontrib><creatorcontrib>Ben Mansour, N</creatorcontrib><creatorcontrib>A Skhiri, H</creatorcontrib><creatorcontrib>Ben Romdhane, H</creatorcontrib><creatorcontrib>Bezdah, L</creatorcontrib><title>Assessment of cardiovascular risk in Tunisia: applying the Framingham risk score to national survey data</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectiveThis paper aims to assess the socioeconomic determinants of a high 10 year cardiovascular risk in Tunisia.SettingWe used a national population based cross sectional survey conducted in 2005 in Tunisia comprising 7780 subjects. We applied the non-laboratory version of the Framingham equation to estimate the 10 year cardiovascular risk.Participants8007 participants, aged 35–74 years, were included in the sample but effective exclusion of individuals with cardiovascular diseases and cancer resulted in 7780 subjects (3326 men and 4454 women) included in the analysis.ResultsMean age was 48.7 years. Women accounted for 50.5% of participants. According to the Framingham equation, 18.1% (17.25–18.9%) of the study population had a high risk (≥20% within 10 years). The gender difference was striking and statistically significant: 27.2% (25.7–28.7%) of men had a high risk, threefold higher than women (9.7%; 8.8–10.5%). A higher 10 year global cardiovascular risk was associated with social disadvantage in men and women; thus illiterate and divorced individuals, and adults without a professional activity had a significantly higher risk of developing a cardiovascular event in 10 years. Illiterate men were at higher risk than those with secondary and higher education (OR=7.01; 5.49 to 9.14). The risk in illiterate women was more elevated (OR=13.57; 7.58 to 24.31). Those living in an urban area had a higher risk (OR=1.45 (1.19 to 1.76) in men and OR=1.71 (1.35 to 2.18) in women).ConclusionsThe 10 year global cardiovascular risk in the Tunisian population is already substantially high, affecting almost a third of men and 1 in 10 women, and concentrated in those more socially disadvantaged.</description><subject>Adult</subject><subject>Aged</subject><subject>Body Mass Index</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Cardiovascular Medicine</subject><subject>Cross-Sectional Studies</subject><subject>Educational Status</subject><subject>Female</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Households</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Obesity, Abdominal - complications</subject><subject>Obesity, Abdominal - epidemiology</subject><subject>Population Surveillance</subject><subject>Prevalence</subject><subject>Risk Assessment</subject><subject>Sex Factors</subject><subject>Smoking - adverse effects</subject><subject>Smoking - epidemiology</subject><subject>Social Class</subject><subject>Socioeconomic Factors</subject><subject>Tunisia - epidemiology</subject><subject>Womens health</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkUFr3DAQhUVoSUKSXxAogl56cSLJGq_VQyGEpgkEcknPYizLWW1tyZXshf33VepNSHuKLhqYbx7v8Qg55-yC87K6bIZNGK0vBONQMKa4ggNyLJiURcUAPryZj8hZShuWnwQFIA7JkVgpVgJUx2R9lZJNabB-oqGjBmPrwhaTmXuMNLr0izpPH2fvksOvFMex3zn_RKe1pTcRhzyvcVjAZEK0dArU4-SCx56mOW7tjrY44Sn52GGf7Nn-PyE_b74_Xt8W9w8_7q6v7otGrsRUWGhazObQqKZDbqBmBgzvBOvqbF5KVdellCtpFbbQqEaCyUk71ahSQtmWJ-TbojvOzWBbk4NF7PUY3YBxpwM6_e_Gu7V-ClsNvKqBl1ngy14ght-zTZMeXDK279HbMCfNawkCBBN1Rj__h27CHHPwv5SsK86EyFS5UCaGlKLtXs1wpp_L1Psy9XOZeikzX316m-P15qW6DFwsQL5-l-IfRmKsrQ</recordid><startdate>20161130</startdate><enddate>20161130</enddate><creator>Saidi, O</creator><creator>Malouche, D</creator><creator>O'Flaherty, M</creator><creator>Ben Mansour, N</creator><creator>A Skhiri, H</creator><creator>Ben Romdhane, H</creator><creator>Bezdah, L</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20161130</creationdate><title>Assessment of cardiovascular risk in Tunisia: applying the Framingham risk score to national survey data</title><author>Saidi, O ; Malouche, D ; O'Flaherty, M ; Ben Mansour, N ; A Skhiri, H ; Ben Romdhane, H ; Bezdah, L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-e5bda903ac9bfa1c580c5c1f20f89554498834474e9ad5b9b45c204f9b93453d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Body Mass Index</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Cardiovascular Medicine</topic><topic>Cross-Sectional Studies</topic><topic>Educational Status</topic><topic>Female</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Households</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Obesity, Abdominal - complications</topic><topic>Obesity, Abdominal - epidemiology</topic><topic>Population Surveillance</topic><topic>Prevalence</topic><topic>Risk Assessment</topic><topic>Sex Factors</topic><topic>Smoking - adverse effects</topic><topic>Smoking - epidemiology</topic><topic>Social Class</topic><topic>Socioeconomic Factors</topic><topic>Tunisia - epidemiology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saidi, O</creatorcontrib><creatorcontrib>Malouche, D</creatorcontrib><creatorcontrib>O'Flaherty, M</creatorcontrib><creatorcontrib>Ben Mansour, N</creatorcontrib><creatorcontrib>A Skhiri, H</creatorcontrib><creatorcontrib>Ben Romdhane, H</creatorcontrib><creatorcontrib>Bezdah, L</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saidi, O</au><au>Malouche, D</au><au>O'Flaherty, M</au><au>Ben Mansour, N</au><au>A Skhiri, H</au><au>Ben Romdhane, H</au><au>Bezdah, L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of cardiovascular risk in Tunisia: applying the Framingham risk score to national survey data</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2016-11-30</date><risdate>2016</risdate><volume>6</volume><issue>11</issue><spage>e009195</spage><epage>e009195</epage><pages>e009195-e009195</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectiveThis paper aims to assess the socioeconomic determinants of a high 10 year cardiovascular risk in Tunisia.SettingWe used a national population based cross sectional survey conducted in 2005 in Tunisia comprising 7780 subjects. We applied the non-laboratory version of the Framingham equation to estimate the 10 year cardiovascular risk.Participants8007 participants, aged 35–74 years, were included in the sample but effective exclusion of individuals with cardiovascular diseases and cancer resulted in 7780 subjects (3326 men and 4454 women) included in the analysis.ResultsMean age was 48.7 years. Women accounted for 50.5% of participants. According to the Framingham equation, 18.1% (17.25–18.9%) of the study population had a high risk (≥20% within 10 years). The gender difference was striking and statistically significant: 27.2% (25.7–28.7%) of men had a high risk, threefold higher than women (9.7%; 8.8–10.5%). A higher 10 year global cardiovascular risk was associated with social disadvantage in men and women; thus illiterate and divorced individuals, and adults without a professional activity had a significantly higher risk of developing a cardiovascular event in 10 years. Illiterate men were at higher risk than those with secondary and higher education (OR=7.01; 5.49 to 9.14). The risk in illiterate women was more elevated (OR=13.57; 7.58 to 24.31). Those living in an urban area had a higher risk (OR=1.45 (1.19 to 1.76) in men and OR=1.71 (1.35 to 2.18) in women).ConclusionsThe 10 year global cardiovascular risk in the Tunisian population is already substantially high, affecting almost a third of men and 1 in 10 women, and concentrated in those more socially disadvantaged.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>27903556</pmid><doi>10.1136/bmjopen-2015-009195</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Body Mass Index Cardiovascular Diseases - epidemiology Cardiovascular Diseases - prevention & control Cardiovascular Medicine Cross-Sectional Studies Educational Status Female Health Knowledge, Attitudes, Practice Households Humans Male Middle Aged Obesity, Abdominal - complications Obesity, Abdominal - epidemiology Population Surveillance Prevalence Risk Assessment Sex Factors Smoking - adverse effects Smoking - epidemiology Social Class Socioeconomic Factors Tunisia - epidemiology Womens health |
| title | Assessment of cardiovascular risk in Tunisia: applying the Framingham risk score to national survey data |
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