Relationship between obesity index and cardiovascular risk in primary care patients on Crete, Greece: a data driven sub-analysis

Relationship between obesity index and cardiovascular risk in primary care patients on Crete, Greece: a data driven sub-analysis

Authors

  • L. Bechraki
  • M. Anastasaki
  • S. Papadakis
  • M. Linardakis
  • D. Anyfantakis
  • C. Lionis
  • E. K. Symvoulakis

Keywords:

Obesity, Cardiovascular risk, Primary care, Lifestyle

Abstract

Background. The present sub-analysis aimed to examine the relationship between obesity index and cardiovascular risk among primary care attendees. Study design. Stratified random sampling was previously used to recruit general practitioners, practicing on Crete island, Greece, whose patients were then enrolled. Methods. Initial sample included 815 primary care attendees (55.7% women; mean age 65.2 years; range 40–98 years). Due to missing values regarding 13 participants, data from 802 patients were included for the current analysis. Body measurements (weight, height), among other bio-clinical parameters, were recorded upon practice visit. The 10-year cardiovascular disease risk was estimated using the European Society of Cardiology (and other societies), 10-year Systematic Coronary Risk Estimation and multivariate linear regression was used to assess relationships between Obesity Index and cardiovascular disease risk. Results. Higher risk is shown to be significantly related with male gender, older age, unemployed/retired status, urban area of living or smoking (p<0.05), as well as with higher levels of obesity index (stand. beta=0.048, p=0.028). Conclusions. Obesity Index may be useful for cardiovascular disease risk prediction and correction at the primary care settings, since obesity is easily addressed during the first medical contact.

References

1. Haslam DW, James WP. Obesity. Lancet 2005 Oct 1; 366(9492): 1197-209. doi: 10.1016/S0140-6736(05)67483-1.

2. Vassilaki M, Linardakis M, Philalithis A. Burden of heart disease in Greece: time to act. Public Health 2014 Oct; 128(10): 940-3. doi: 10.1016/j.puhe.2014.08.007. Epub 2014 Oct 22.

3. Girvalaki, C, Vardavas C, Papandreou C, et al. Trends in metabolic syndrome risk factors among adolescents in rural Crete between 1989 and 2011. Hormones (Athens) 2014 Apr-Jun; 13(2): 259-67. doi: 10.1007/BF03401340.

4. Filippatos TD, Kyrou I, Georgousopoulou EN, et al. Modeling anthropometric indices in relation to 10-year (2002-2012) incidence of cardiovascular disease, among apparently healthy individuals: The ATTICA study. Diabetes Metab Syndr 2017 Dec; 11(Suppl 2): S789-S795. doi: 10.1016/j.dsx.2017.05.018. Epub 2017 Jun 3.

5. Anastasaki M, Papadakis S, Linardakis M, Anyfantakis D, Symvoulakis EK, Lionis C; Cretan Primary Care Research Group. Burden of metabolic syndrome and cardiovascular risk among primary care patients in Crete, Greece: A descriptive study. Eur J Gen Pract 2020 Dec; 26(1): 166-74. doi: 10.1080/13814788.2020.1851676.

6. World Health Organization (WHO). Available on: https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi [Last accessed: 2021 Feb 3].

7. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016 Aug 1; 37(29):2315-2381. doi: 10.1093/eurheartj/ehw106.

8. Kollia N, Panagiotakos DB, Georgousopoulou E, et al. Exploring the association between low socioeconomic status and cardiovascular disease risk in healthy Greeks, in the years of financial crisis (2002-2012): The ATTICA study. Int J Cardiol 2016 Nov 15; 223: 758-63. doi: 10.1016/j.ijcard.2016.08.294. Epub 2016 Aug 20.

9. Calle EE, Thun MJ, Petrelli JM, Rodriguez C. Heath CW Jr. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999 Oct 7; 341(15): 1097-105. doi: 10.1056/NEJM199910073411501.

10. Song Y, Manson JE, Meigs JB, Ridker PM, Buring JE, Liu S. Comparison of usefulness of body mass index versus metabolic risk factors in predicting 10-year risk of cardiovascular events in women. Am J Cardiol 2007 Dec 1; 100(11): 1654-8. doi: 10.1016/j.amjcard.2007.06.07.

11. Marques-Vidal P, Bochud M, Mooser V, Paccaud F, Waeber G, Vollenweider P. Obesity markers and estimated 10-year fatal cardiovascular risk in Switzerland. Nutr Metab Cardiovasc Dis 2009 Sep; 19(7): 462-8. doi: 10.1016/j.numecd.2008.10.001. Epub 2009 Jan 29.

12. Kreuter MW, Scharff DP, Brennan LK, Lukwago SN. Physician recommendations for diet and physical activity: which patients get advised to change? Prev Med 1997 Nov-Dec; 26(6):825-33. doi: 10.1006/pmed.1997.0216.

13. Rakita V, Homko CJ, Kashem A, Memon N, Bove AA. Factors Influencing Physician Counseling on Cardiovascular Risk. J Prim Care Community Health 2016 Apr; 7(2): 65-70. doi: 10.1177/2150131915614963. Epub 2015 Nov 16.

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Published

2025-09-04

Issue

Section

Original research

How to Cite

1.
Bechraki L, Anastasaki M, Papadakis S, et al. Relationship between obesity index and cardiovascular risk in primary care patients on Crete, Greece: a data driven sub-analysis. Ann Ig. 2025;34(3):259-265. doi:10.7416/ai.2021.2464