Prevalence of cardiovascular risk factors in a semi-urban population in Indonesia [Early detection of cardiovascular risk factors as primary prevention amongst North Sumatera adults (ECARDIA-NS) study]

Background Controlling cardiovascular risk factors (CVRF) such as hypertension, dyslipidemia, diabetes, obesity and smoking has been shown to be effective in reducing the risk of developing cardiovascular diseases such as ischaemic heart disease and stroke. However, previous nationwide health surveys largely relied on surveys and interviews with only a limited subset of subjects undergoing formal testing with oral glucose tolerance tests and biochemical lipid profiling. Methods This study aimed to provide an estimation of the prevalence of CVRFs in a population of adults in the province of North Sumatera. From March-December 2024, 1208 adults (80% female) aged 40 years and older with no apparent cardiovascular disease were opportunistically recruited from 15 screening sites in Kota Medan, Kota Tebing Tinggi and Kabupaten Langkat. Participants underwent anthropometric and blood pressure measurements, followed by a single lead electrocardiogram and blood draw for biochemical analysis of HbA1c and lipid panel. Subjects were surveyed regarding their demographics, medical history. A subset of participants was interviewed and scored on their knowledge, attitudes and practices (KAP) with a 14-point questionnaire. Results Overall, 56% of the population had hypertension, 44% had dyslipidemia and 17% had diabetes. Most of these subjects were newly diagnosed based on measurements obtained during this screening study. 69% of participants were obese, a further 15% were overweight and 83% had elevated waist circumference. 1.3% of subjects had atrial fibrillation. Multivariable logistic regression showed significant associations between presence of CVRF and older age, obesity and elevated waist circumference. The median knowledge score was 5/10 and the median combined KAP score was 9/14. Further regression analysis suggested that KAP scores were associated with education level but not occupation. We also did not find any significant relationship between KAP score and presence of CVRFs. Conclusions This community-based opportunistic screening study of 1208 adults in a semi-urban population in North Sumatera revealed a high burden of cardiometabolic disease as well as gaps in knowledge regarding CVRFs and how to control them. This suggests that still more work can be done in the region to address these.