Cardiovascular Risk Factors in Socioeconomically Disadvantaged Populations in a Suburb of the Largest City in Western Romania
<p>Graphical representation of age between subjects with and without HCA diabetes including notched box-and-whisker and violin plot representations (notched box-and-whisker, as well as horizontal lines, markers, connecting lines, and error bars, to indicate 95% confidence intervals for medians).</p> "> Figure 2
<p>Graphical depiction of BMI between male and female participants, including notched box-and-whisker and violin plot representations (notched box-and-whisker, as well as horizontal lines, markers, connecting lines, and error bars, indicate 95% confidence intervals for medians).</p> "> Figure 3
<p>Graphical representation of systolic blood pressure between male and female participants, including notched box-and-whisker and violin plot representations (notched box-and-whisker, as well as horizontal lines, markers, connecting lines, and error bars, indicate 95% confidence intervals for medians).</p> "> Figure 4
<p>Graphical representation of blood glucose levels between male and female participants, including notched box-and-whisker and violin plot representations (notched box-and-whisker, as well as horizontal lines, markers, connecting lines, and error bars, indicate 95% confidence intervals for medians).</p> "> Figure 5
<p>Pie chart graphical representation of included subjects.</p> ">
Abstract
:1. Introduction
2. Materials and Methods
2.1. General Information
2.2. Sample Size
2.3. Selection Criteria
- (a)
- Severe material deprivation rate (SMD): population unable to afford at least four out of nine predefined material items essential for an adequate quality of life. These items include housing, heating, durable goods, and access to healthcare.
- (b)
- At-risk-of-poverty rate: people who are at risk of falling below the poverty threshold (typically set at 60% of the national median equivalized disposable income). Eurostat provides information on at-risk-of-poverty rates for various demographic groups, including age, gender, and household composition.
- (c)
- Low work intensity indicator: we analyzed data related to low work intensity, focusing on people aged 18–59 years living in households where adults (aged 18–59, excluding students aged 18–24) worked a working time equal to or less than 20% of their total combined work-time potential during the previous year [18].
2.4. Study Design and Analysis
2.5. Statistical Analysis
3. Results
3.1. Demographic Features
3.2. Age Distribution and Its Association with Hereditary and Personal Pathologic Antecedents
3.3. Body Mass Index (BMI) Comparison across Hereditary and Personal Pathologic Conditions
3.4. Gender-Based Variations in Cardiovascular and Metabolic Risk Factors
3.5. Prevalence and Distribution of Cardiovascular Risk Factors in the Study Population
3.6. Relative Risk (RR) and Odds Ratio (OR) for Various Outcomes Based on Associated Risk Factors
4. Discussion
4.1. Cardiovascular Risk Factors among Socioeconomically Disadvantaged Populations in Western Romania: A Comparative Analysis with National and International Studies
4.2. Comparative Analysis of Cardiovascular Risk Factors in Socioeconomically Disadvantaged Populations: Insights from Recent Romanian Studies
4.3. Strategies to Reduce Cardiovascular Risk in Socioeconomically Disadvantaged Populations: Addressing Health Equity through Targeted Interventions and Policy Initiatives within the Romanian Population
4.4. Limitations
4.5. Future Directions
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
CVD | cardiovascular disease |
SDOHs | social determinants of health |
SES | socioeconomic status |
CVRFs | cardiovascular risk factors |
EU | European Union |
EU-SILC | European Union Statistics on Income and Living Conditions |
SMD | severe material deprivation rate |
IQR | interquartile range |
HCA | hereditary–collateral antecedents |
PPA | personal pathologic antecedents |
BMI | body mass index |
SBP | systolic blood pressure |
DBP | diastolic blood pressure |
HDL | High-Density Lipoprotein |
LDLc | Low-Density Lipoprotein Cholesterol |
ATP III | Adult Treatment Panel III |
HbA1c | Hemoglobin A1c |
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Condition | Number of Subjects | Percentage |
---|---|---|
HCA (diabetes) | 115 | 8.02% |
HCA (cardiovascular) | 126 | 8.79% |
PPA (diabetes) | 106 | 7.39% |
PPA (coronary disease) | 55 | 3.83% |
PPA (blood pressure) | 510 | 35.58% |
PPA (dyslipidemia) | 305 | 21.28% |
Category | Parameter | No of Subjects (Percentage) |
---|---|---|
BMI | ||
Underweight | <18.5 kg/m2 | 33 (2.30%) |
Normal weight | 18.5–24.9 kg/m2 | 396 (27.63%) |
Overweight | 25–29.9 kg/m2 | 484 (33.77%) |
Obese | 30–34.9 kg/m2 | 304 (21.21%) |
Morbidly obese | ≥35 kg/m2 | 216 (15.07%) |
Smoker status | ||
Non-smoker | 830 (58.49%) | |
Active smoker | 450 (31.71%) | |
Ex-smoker | Smoke-free for at least 28 days | 139 (9.79%) |
Systolic blood pressure | ||
Optimal | <120 mmHg | 394 (27.84%) |
Normal | 120–129 mmHg | 282 (19.92%) |
High normal | 130–139 mmHg | 251 (17.73%) |
Grade 1 hypertension | 140–159 mmHg | 319 (22.54%) |
Grade 2 hypertension | 160–179 mmHg | 117 (8.26%) |
Grade 3 hypertension | ≥180 mmHg | 52 (3.67%) |
Diastolic blood pressure | ||
Optimal | <80 mmHg | 400 (28.24%) |
Normal | 80–84 mmHg | 263 (18.57%) |
High normal | 85–89 mmHg | 220 (15.53%) |
Grade 1 hypertension | 90–99 mmHg | 315 (22.24%) |
Grade 2 hypertension | 100–109 mmHg | 155 (10.94%) |
Grade 3 hypertension | ≥110 mmHg | 63 (4.68%) |
Fasting blood glucose level | ||
Normal | <100 mg/dL | 381 (31.90%) |
Alteration in fasting glucose | 100–125 mg/dL | 617 (51.67%) |
Alteration in fasting glucose (diabetes category) | ≥126 mg/dL | 196 (16.41%) |
HDL level | ||
Low | <40 mg/dL | 218 (18.07%) |
Intermediate | 40–59 mg/dL | 637 (52.81%) |
High | ≥60 mg/dL | 351 (29.10%) |
LDLc level | ||
Optimal | < 100 mg/ dL | 451 (37.83%) |
Near optimal/above optimal | 100–129 mg/dL | 331 (27.76%) |
Borderline high | 130–159 mg/dL | 238 (19.96%) |
High | 160–189 mg/dL | 127 (10.65%) |
Very high | ≥190 mg/dL | 45 (3.77%) |
Fasting triglyceride level | ||
Normal | <150 mg/dL | 840 (69.65%) |
Mild hypertriglyceridemia | 150–499 mg/dL | 352 (29.18%) |
Moderate hypertriglyceridemia | 500–886 mg/dL | 11 (0.91%) |
Very high or severe hypertriglyceridemia | >886 mg/dL | 3 (0.24%) |
Condition | Age of Subjects with Condition | Age of Subjects without Condition | p-Value |
---|---|---|---|
HCA (diabetes) | 49; (36, 55.75) | 52; (38, 65) | 0.014 |
HCA (cardiovascular) | 48; (36, 59) | 52; (38.75, 65) | 0.006 |
PPA (diabetes) | 65; (57, 70) | 51; (37, 64) | <0.001 |
PPA (coronary disease) | 64; (57.50, 69.75) | 51; (38, 64) | <0.001 |
PPA (blood pressure) | 65; (57, 70) | 43; (32, 55) | <0.001 |
PPA (dyslipidemia) | 66; (58, 70) | 47; (34, 60) | <0.001 |
Smoker status | 48; (36, 62) | 54; (40, 65) | <0.001 |
Condition | BMI of Subjects with Condition | BMI of Subjects without Condition | p-Value |
---|---|---|---|
HCA (diabetes) | 29.62; (25.77, 34.56) | 27.74; (24, 32) | 0.011 |
HCA (cardiovascular) | 28.30; (23.70, 32.87) | 28; (24.15, 32) | 0.847 |
PPA (diabetes) | 31.63; (28.53, 36.07) | 27.64; (24, 31.80) | <0.001 |
PPA (coronary disease) | 29.36; (25.95, 34.58) | 27.93; (24.02, 32) | 0.033 |
PPA (blood pressure) | 30; (27, 34.44) | 26.53; (23, 31.04) | <0.001 |
PPA (dyslipidemia) | 29.40; (26.37, 34) | 27.10; (23.70, 31.96) | <0.001 |
Smoker status | 27.66; (23.90; 31.71) | 28; (24.52, 32.36) | 0.031 |
Parameter | Male Gender | Female Gender | p-Value |
---|---|---|---|
BMI | 28.70; (25, 32.11) | 27.43; (23.87, 32) | 0.021 |
Systolic blood pressure | 134; (121, 150) | 128; (115,144) | <0.001 |
Diastolic blood pressure | 86; (80, 96) | 85; (76, 92) | 0.001 |
Blood glucose level | 108; (100, 120) | 103; (95, 116) | <0.001 |
Total cholesterol level | 191; (160.75, 221) | 196; (166, 228) | 0.062 |
HDL level | 45; (38, 55) | 54; (45, 64) | <0.001 |
LDLc level | 111; (87, 143) | 114; (88, 140) | 0.562 |
Fasting triglyceride level | 125; (86, 191.25) | 107; (74, 153.25) | <0.001 |
HbA1c | 6.2; (5.80, 7.45) | 6.1; (5.70, 6.87) | 0.487 |
Classification | Number of Subjects | Percentage |
---|---|---|
Subjects without risk factors | 218 | 15.21% |
Subjects with 1 risk factor | 435 | 30.35% |
Subjects with 2 risk factors | 305 | 21.28% |
Subjects with 3 risk factors | 268 | 18.70% |
Subjects with 4 risk factors | 150 | 10.46% |
Subjects with 5 risk factors | 53 | 3.69% |
Subjects with 6 risk factors | 4 | 0.27% |
Outcome | Group | RR (p-Value) | OR (p-Value) |
---|---|---|---|
Diabetes | HCA (diabetes) | 3.5 (<0.001) | 4.19 (<0.001) |
Blood glucose level ≥ 126 mg/dL | BMI ≥ 25 kg/m2 | 3.2 (<0.001) | 3.76 (<0.001) |
Blood glucose level ≥ 126 mg/dL | BMI ≥ 30 kg/m2 | 2.26 (<0.001) | 2.68 (<0.001) |
SBP ≥ 140 mmHg | Blood glucose level ≥ 126 mg/dL | 1.66 (<0.001) | 2.48 (<0.001) |
SBP ≥ 160 mmHg | Blood glucose level ≥ 126 mg/dL | 2.56 (<0.001) | 3.12 (<0.001) |
SBP ≥ 180 mmHg | Blood glucose level ≥ 126 mg/dL | 2.54 (<0.001) | 2.68 (0.001) |
DBP ≥ 90 mmHg | Blood glucose level ≥ 126 mg/dL | 1.37 (<0.001) | 1.81 (<0.001) |
DBP ≥ 100 mmHg | Blood glucose level ≥ 126 mg/dL | 1.61 (<0.001) | 1.82 (0.001) |
DBP ≥ 110 mmHg | Blood glucose level ≥ 126 mg/dL | 1.69 (0.066) | 1.75 (0.068) |
PPA (coronary disease) | HCA (Cardiovascular) | 1.71 (0.144) | 1.76 (0.148) |
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Dumitrescu, A.; Vitcu, G.M.; Stoica, S.; Susa, S.R.; Stoicescu, E.R. Cardiovascular Risk Factors in Socioeconomically Disadvantaged Populations in a Suburb of the Largest City in Western Romania. Biomedicines 2024, 12, 1989. https://doi.org/10.3390/biomedicines12091989
Dumitrescu A, Vitcu GM, Stoica S, Susa SR, Stoicescu ER. Cardiovascular Risk Factors in Socioeconomically Disadvantaged Populations in a Suburb of the Largest City in Western Romania. Biomedicines. 2024; 12(9):1989. https://doi.org/10.3390/biomedicines12091989
Chicago/Turabian StyleDumitrescu, Andreea, Gabriela Mut Vitcu, Svetlana Stoica, Septimiu Radu Susa, and Emil Robert Stoicescu. 2024. "Cardiovascular Risk Factors in Socioeconomically Disadvantaged Populations in a Suburb of the Largest City in Western Romania" Biomedicines 12, no. 9: 1989. https://doi.org/10.3390/biomedicines12091989