Achievements of primary prevention targets in individuals with high risk of cardiovascular disease: an 8-year follow-up of the Tromsø study

Author:

Hagen Amalie Nilsen1ORCID,Ariansen Inger2ORCID,Hanssen Tove Aminda34,Lappegård Knut Tore15,Eggen Anne Elise6,Løchen Maja-Lisa36ORCID,Njølstad Inger6ORCID,Wilsgaard Tom6,Hopstock Laila Arnesdatter6ORCID

Affiliation:

1. Department of Medicine, Nordland Hospital , Parkveien 96, Nordland, 8005 Bodø , Norway

2. Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health , Folkehelseinstituttet, Postboks 222 Skøyen, 0213 Oslo , Norway

3. Department of Cardiology, University Hospital of North Norway , Universitetssykehuset Nord-Norge HF Postboks 100, 9038 Tromsø , Norway

4. Department of Health and Care Sciences, UiT The Arctic University of Norway , UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø , Norway

5. Department of Clinical Medicine, UiT The Arctic University of Norway , UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø , Norway

6. Department of Community Medicine, UiT The Arctic University of Norway , UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø , Norway

Abstract

Abstract Aims To study change over 8 years in cardiovascular risk, achievement of national guideline-based treatment targets of lipids, blood pressure (BP) and smoking in primary prevention of cardiovascular disease (CVD), medication use, and characteristics associated with target achievement among individuals with high CVD risk in a general population. Methods and results We followed 2524 women and men aged 40–79 years with high risk of CVD attending the population-based Tromsø study in 2007–08 (Tromsø6) to their participation in the next survey in 2015–16 (Tromsø7). We used descriptive statistics and regression models to study change in CVD risk and medication use, and characteristics associated with treatment target achievement. In total, 71.4% reported use of BP- and/or lipid-lowering medication at second screening. Overall, CVD risk decreased during follow-up, with a larger decrease among medication users compared with non-users. Treatment target achievement was 31.0% for total cholesterol <5 mmol/L, 27.3% for LDL cholesterol <3 mmol/L, 43.4% for BP <140/90 (<135/85 if diabetes) mmHg, and 85.4% for non-smoking. A total of 9.8% reached all treatment targets combined. Baseline risk factor levels and current medication use had the strongest associations with treatment target achievement. Conclusion We found an overall improvement in CVD risk factors among high-risk individuals over 8 years. However, guideline-based treatment target achievement was relatively low for all risk factors except smoking. Medication use was the strongest characteristic associated with achieving treatment targets. This study has demonstrated that primary prevention of CVD continues to remain a major challenge.

Funder

Northern Norway Health Authority

Publisher

Oxford University Press (OUP)

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