May 4, 2020Open Access
Primary care use and cardiovascular disease risk in Russian 40–69 year olds: a cross-sectional study
Key Result
Among Russian adults aged 40-69 without known CVD, 23.1% had no recent primary care contact, which was associated with high CVD risk factors including smoking (37%) and untreated hypertension (32%).
Study Design
Type
Cross-Sectional (n=2,774)
Multicenter
Yes
Structured PICO
What are the characteristics and cardiovascular risk profiles of Russian adults aged 40-69 without known CVD who lack recent primary care contact?
P
Population
2,774 participants aged 40-69 years with no self-reported cardiovascular disease (CVD) history from Arkhangelsk and Novosibirsk, Russian Federation.
I
Intervention
Recent primary care contact (seeing a primary care doctor in the past year or attending a general health check under the 2013 Dispansarisation programme)
C
Comparator
No recent primary care contact
O
Outcome
CVD risk (10-year SCORE risk) and health status characteristics
A significant proportion of middle-aged Russian adults without known CVD lack recent primary care contact, and this group exhibits high rates of untreated cardiovascular risk factors.
Abstract
BACKGROUND: The Russian Federation has very high cardiovascular disease (CVD) mortality rates compared with countries of similar economic development. This cross-sectional study compares the characteristics of CVD-free participants with and without recent primary care contact to ascertain their CVD risk and health status. METHODS: A total of 2774 participants aged 40-69 years with no self-reported CVD history were selected from a population-based study conducted in Arkhangelsk and Novosibirsk, Russian Federation, 2015-2018. A range of co-variates related to socio-demographics, health and health behaviours were included. Recent primary care contact was defined as seeing primary care doctor in the past year or having attended a general health check under the 2013 Dispansarisation programme. RESULTS: The proportion with no recent primary care contact was 32.3% (95% CI 29.7% to 35.0%) in males, 16.3% (95% CI 14.6% to 18.2%) in females, and 23.1% (95% CI 21.6% to 24.7%) overall. In gender-specific age-adjusted analyses, no recent contact was also associated with low education, smoking, very good to excellent self-rated health, no chest pain, CVD 10-year SCORE risk 5+%, absence of hypertension control, absence of hypertension awareness and absence of care-intensive conditions. Among those with no contact: 37% current smokers, 34% with 5+% 10-year CVD risk, 32% untreated hypertension, 20% non-anginal chest pain, 18% problem drinkers, 14% uncontrolled hypertension and 9% Grade 1-2 angina. The proportion without general health check attendance was 54.6%. CONCLUSION: Primary care and community interventions would be required to proactively reach sections of 40-69 year olds currently not in contact with primary care services to reduce their CVD risk through diagnosis, treatment, lifestyle recommendations and active follow-up.