Cardiovascular risk and lifestyle advice from physician: rates recalled by patients and predicting factors

Shin, Ho Cheol

Abstract

BACKGROUND: The relation between lifestyle and chronic diseases is now well established. For example, smoking, high dietary fat intake, lack of exercise have been identified as independent risk factors for the development of cardiovascular disease. So changing risk factors related to lifestyle is very important to minimize the burden of many kinds of chronic diseases including cardiovascular disease and cancer. Patients who are at increased risk of developing chronic diseases should be identified and if this increased risk is modifiable unhealthy behavior, appropriate advice should be given to encourage behavioral chang. That is one of the most important role of primary care physician. However we do not know how often patients with varying risk factors receive lifestyle advice from their physician in Korea. This study is to know how often patients having cardiovasculr risk factors receive lifestyle advice from their physician and what is the predicting factor of that.
METHODS
Cross-sectional study was done by direct interview. Subjects were 3151 people aged 19-61 years who had consulted a physician at least once during 12 months before interview and who were employee of the national company which had branches nationwide. Possible cardiovascular risk factors were identified from the result of health check. Subjects were asked whether they had received lifestyle advice for each of identified risk factors from physician. The data about sociodemographic characterisitics also were collected during interview. We used x(2) test for trend to establish whether increasing risk levels were associated with a change in the likelihood of receiving advice about modifying risky behaviors.
RESULTS
The proportion of smokers who received advice about smoking was just 29.3%, but smoking was unhealthy behavior most likely to receive advice from physician. The proportion of subjects receiving advice about exercise was only 8.6% and was significantly higher among those who were diabetic (27.6%), hypertensive(22.7%), or who had a history of cardiovascular disease(36.4%). The proportion of subjects receiving advice about low dietary fat intake was only 6.8%. The proportion was higher among obese subjects(13.7%) and rose with increasing serum cholesterol lev el(x(2)Trend=9.46, df=1; p<0.01). The proportion of subjects receiving advice about alcohol consumption was 18.1%. Women were significantly less likely than men to receive advice about smoking, exercise, alcohol consumption except about dietary intake and weight control. Age was significantly associated with the likelihood of receiving lifestyle advice.
CONCLUSION
Patients reported a low rate of receiving lifestyle advice from physician. This results suggest that more preventive advice about healthy lifestyle should be given in primary care.