PERCEPTION OF CVD RISK FACTORS BY DIFFERENT...

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!