Heart Health

28 September 2007

Docs skip vital heart checks

Doctors are more aware of the link between abdominal fat and heart disease, but most still only screen for classic risk factors, a global survey, including South Africa, finds.

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Results from a survey conducted in 28 countries, including South Africa, reveal an increase in physician awareness regarding the link between too much fat around the waist (abdominal obesity) and the development of diabetes and heart disease.

However, primary care physicians are still more likely to screen and manage classic cardiometabolic risk factors such as type 2 diabetes, high levels of bad cholesterol and high blood pressure compared with emerging risk factors such as abdominal obesity, low levels of good cholesterol and high levels of fat in the blood (also known as triglycerides).

Additionally, over 80 percent of primary care physicians feel their patients are not adequately educated about how they can reduce cardiometabolic risk factors associated with these diseases - a trend also seen in South Africa.

Global cardiometabolic risk represents the overall risk of developing type 2 diabetes and heart disease due to a cluster of modifiable risk factors, including:

  • high blood sugar,
  • unhealthy cholesterol (high levels of LDL-cholesterol or low levels of HDL-cholesterol in the blood),
  • high levels of triglycerides in the blood,
  • high blood pressure, or
  • too much fat around the waist (as measured by waist circumference).

Research shows that this cluster of modifiable factors can increase the risk of developing type 2 diabetes and heart disease. It is therefore important that these cardiometabolic risk factors are measured regularly in order to assess the risk of type 2 diabetes and heart disease.

Cardiometabolic factors rated high
Results released this week from the Shape of the Nations 2007 survey show that about three-quarters of physicians rate classical cardiometabolic risk factors such as type 2 diabetes, high blood pressure, smoking and high LDL-cholesterol ("bad" cholesterol) levels as the highest risk factors for heart disease.

However, they are less likely to state a high level of concern for emerging cardiometabolic risk factors that put their patients at risk, such as abdominal obesity, high levels of triglycerides in the blood and low levels of HDL-cholesterol ("good" cholesterol).

The survey also demonstrates that only six percent of the general population and 11 percent of at-risk patients recognise that type 2 diabetes is a cardiometabolic risk factor. Furthermore, only about one in three at-risk patients reported that their doctor or nurse had ever measured emerging cardiometabolic risk factors.

Shape of the Nations 2007
Over 11 000 people across 28 countries took part in the Shape of the Nations 2007 Survey. This included 381 people from South Africa.

The survey assessed awareness, understanding and behaviours with respect to cardiometabolic risk factors across three groups: primary care physicians, a population at risk for heart disease and the general population.

A high percentage of primary care physicians were able to identify classical cardiometabolic risk factors for heart disease. The survey showed that, in South Africa, high blood pressure is recognised by 89 percent of primary care physicians as a risk factor, followed by high blood sugar at 88 percent, obesity at 82 percent and smoking at 78 percent.

However, when it comes to recognising emerging risk factors, only 36 percent of physicians recognised abdominal obesity as a cardiometabolic risk factor, while 30 percent recognised high levels of triglycerides in the blood and 23 percent recognised low levels of HDL cholesterol as cardiometabolic risk factors.

The Shape of the Nations is a joint initiative between sanofi-aventis, the WHF, the International Association for the Study if Obesity and the International Diabetes Federation.

- (Health24, September 2007)

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