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      Modifiable cardiovascular risk factors in adults aged 40–79 years in Germany with and without prior coronary heart disease or stroke

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          Abstract

          Background

          Control of modifiable cardiovascular disease (CVD) risk factors has substantially reduced CVD mortality, but risk factor levels in populations may change and need continuous monitoring. This study aims to provide current estimates of the prevalence of these risk factors in Germany according to sex and history of coronary heart disease (CHD) or stroke.

          Methods

          The analyses were based on data from the German Health Interview and Examination Survey for Adults (DEGS1; age 40–79 years, n = 5101), which is a cross-sectional population-based examination survey. CVD risk factors were defined according to recommendations in the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2012.

          Results

          The mean age was 57 years and 52 % were female; 493 participants had prior CHD and 163 participants a prior stroke. The overall prevalence of behavioural risk factors ranged from 17.9 % for high risk alcohol consumption to 90 % for low vegetable intake. Blood pressure ≥ 140/90 mmHg was found in 21 % and 69 % had total cholesterol ≥ 5.0 mmol/l. Only 16 % met the targets for five behavioural factors combined (smoking, physical activity, fruit intake, alcohol intake and obesity), 13 % of those with and 16 % of those without CHD or stroke. The prevalences of most behavioural risk factors were higher among men compared to women.

          Conclusions

          There is a high prevention potential from modifiable cardiovascular risk factors in the general population aged 40–79 years in Germany and among those with prior CHD or stroke. Risk factors are often co-occurring, are interrelated and require combined educational, behavioral, medical and policy approaches.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-015-1929-5) contains supplementary material, which is available to authorized users.

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          Most cited references19

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          Constructions of masculinity and their influence on men's well-being: a theory of gender and health.

          Men in the United States suffer more severe chronic conditions, have higher death rates for all 15 leading causes of death, and die nearly 7 yr younger than women. Health-related beliefs and behaviours are important contributors to these differences. Men in the United States are more likely than women to adopt beliefs and behaviours that increase their risks, and are less likely to engage in behaviours that are linked with health and longevity. In an attempt to explain these differences, this paper proposes a relational theory of men's health from a social constructionist and feminist perspective. It suggests that health-related beliefs and behaviours, like other social practices that women and men engage in, are a means for demonstrating femininities and masculinities. In examining constructions of masculinity and health within a relational context, this theory proposes that health behaviours are used in daily interactions in the social structuring of gender and power. It further proposes that the social practices that undermine men's health are often signifiers of masculinity and instruments that men use in the negotiation of social power and status. This paper explores how factors such as ethnicity, economic status, educational level, sexual orientation and social context influence the kind of masculinity that men construct and contribute to differential health risks among men in the United States. It also examines how masculinity and health are constructed in relation to femininities and to institutional structures, such as the health care system. Finally, it explores how social and institutional structures help to sustain and reproduce men's health risks and the social construction of men as the stronger sex.
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            Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: a global and regional analysis on reduction of cardiovascular-disease risk.

            Cardiovascular disease accounts for much morbidity and mortality in developed countries and is becoming increasingly important in less developed regions. Systolic blood pressure above 115 mm Hg accounts for two-thirds of strokes and almost half of ischaemic heart disease cases, and cholesterol concentrations exceeding 3.8 mmol/L for 18% and 55%, respectively. We report estimates of the population health effects, and costs of selected interventions to reduce the risks associated with high cholesterol concentrations and blood pressure in areas of the world with differing epidemiological profiles. Effect sizes were derived from systematic reviews or meta-analyses, and the effect on health outcomes projected over time for populations with differing age, sex, and epidemiological profiles. Incidence data from estimates of burden of disease were used in a four-state longitudinal population model to calculate disability-adjusted life years (DALYs) averted and patients treated. Costs were taken from previous publications, or estimated by local experts, in 14 regions. Non-personal health interventions, including government action to stimulate a reduction in the salt content of processed foods, are cost-effective ways to limit cardiovascular disease and could avert over 21 million DALYs per year worldwide. Combination treatment for people whose risk of a cardiovascular event over the next 10 years is above 35% is also cost effective leading to substantial additional health benefits by averting an additional 63 million DALYs per year worldwide. The combination of personal and non-personal health interventions evaluated here could lower the global incidence of cardiovascular events by as much as 50%.
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              German health interview and examination survey for adults (DEGS) - design, objectives and implementation of the first data collection wave

              Background The German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources. Methods/design The first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18–79 years of age. Another 4193 persons 18–79 years of age were recruited for DEGS1 in 2008–2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18–79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010. Discussion DEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma, allergies, cardiovascular conditions, diabetes mellitus, and musculoskeletal diseases. Other core topics include vaccine-preventable diseases and immunization status, nutritional deficiencies, health in older age, and the association between health-related behavior and mental health.
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                Author and article information

                Contributors
                TruthmannJ@rki.de
                BuschM@rki.de
                Scheidt-NaveC@rki.de
                MensinkG@rki.de
                GoesswaldA@rki.de
                Matthias.Endres@charite.de
                NeuhauserH@rki.de
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                24 July 2015
                24 July 2015
                2015
                : 15
                : 701
                Affiliations
                [ ]Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
                [ ]German Center for Cardiovascular Research (DZHK), Berlin, Germany
                [ ]Department and Out-Patient Care of Neurology, Charité, Universitätsmedizin Berlin, Berlin, Germany
                [ ]Center for Stroke Research Charité, Universitätsmedizin Berlin, Berlin, Germany
                [ ]German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
                Article
                1929
                10.1186/s12889-015-1929-5
                4513378
                26205716
                9bade1f0-bb11-4811-bada-42d71de3d0c2
                © Truthmann et al. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 January 2015
                : 11 June 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Public health
                coronary heart disease,stroke,prevention,risk factors
                Public health
                coronary heart disease, stroke, prevention, risk factors

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