Stratified management for cardiovascular diseases risk in community population based on China-PAR
10.3760/cma.j.cn114798-20220701-00716
- VernacularTitle:依据China-PAR风险评估模型对社区人群进行分层管理的效果初探
- Author:
Xue BAI
1
;
Ying NIE
;
Shihuan LUO
;
Xinhuan ZHANG
;
Ronghui XIA
;
Yahui SUN
;
Yuntao LU
Author Information
1. 北京交通大学社区卫生服务中心，北京100044
- Keywords:
Cardiovascular diseases;
Risk assessment;
Primary prevention
- From:
Chinese Journal of General Practitioners
2023;22(3):271-277
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of stratified management of cardiovascular diseases risk in community population based on China-PAR.Methods:It was a single arm study. Beijing Jiaotong University faculty and staff who participated in annual health check-up from 2019 to 2021 and met the inclusion/exclusion criteria were enrolled in the study. The general data, physical examination and laboratory test results, including age, residence region, waist circumference, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C),blood pressure (BP), taking antihypertensive drugs,diabetes, family history of cardiovascular diseases,were collected. Participants were stratified according to China-PAR assessment model and then stratified management was carried out. For low-risk populations, family doctors provided online guidance or outpatient follow-up if necessary after their first interview. For middle and high-risk groups, outpatient and telephone follow-up were arranged in addition to online guidance. Relevant examinations were completed and drug treatment or adjustment were given by doctors when necessary. Frequency of outpatient follow-up for middle and high-risk groups was different and patients in these two groups were scored again at the end of 2-year follow-up.Results:A total 284 participants were enrolled,197 participants (69.4%) were males with a age of (46.9±8.8) years. Among them, 205 participants (72.2%) were in low-risk group, including 136 males (66.3%), and their 10-year risk of cardiovascular diseases was (2.5±0.1)%; 59 participants (20.8%) were in middle-risk group, including 43 males (72.9%), and their 10-year risk of cardiovascular diseases was (7.1±0.2)%;20 participants (7.0%) were in high-risk group,including 18 males (90.0%) and their 10-year risk of cardiovascular diseases was (14.0±1.1)%. After 2 years follow-up, the proportion of dietary imbalances and alcohol drinking, waist circumference, blood pressure, fasting glucose levels and risk score decreased significantly in high risk group ( P<0.05). The proportion of dietary imbalances, waist circumference, blood pressure, total cholesterol, and LDL-C levels decreased significantly in medium risk group ( P<0.05). In high-risk group, 2 participants (10.0%) converted to low-risk, 8 participants (40.0%) converted to middle-risk. In middle-risk group, 5 participants (8.5%) converted to low-risk and 7 participants (11.9%) converted to high-risk. Conclusion:The risk factors and risk stratification of cardiovascular disease in community population can be improved by stratified management based on China-PAR risk assessment model.
