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Five-year incidence of cardiovascular disease and its predictors in Greece: the ATTICA study

Department of Dietetics – Nutrition, Harokopio University, Athens, Greece

Christos Pitsavos

First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece

Christina Chrysohoou

First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece

Ioannis Skoumas

First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece

Christodoulos Stefanadis

First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece

Abstract

The 5-year incidence of cardiovascular disease (CVD) and its determinants, in a sample of men and women from Greece, was evaluated. From May 2001 to December 2002, 1514 men and 1528 women (> 18 years old) without any clinical evidence of CVD, living in the Attica area, Greece, were enrolled in the ATTICA study. In 2006, a group of experts performed the 5-year follow-up (941 of the 3042 (31%) participants were lost to follow-up). Development of CVD (coronary heart disease, acute coronary syndromes, stroke, or other CVD) during the follow-up period was defined according to WHO-ICD-10 criteria. The 5-year incidence of CVD was 11.0% in men and 6.1% in women (p < 0.001); the case fatality rate was 1.6%. Multi-adjusted logistic regression analysis revealed that increased age (odds ratio per year = 1.09, p = 0.04), waist-to-hip ratio (odds ratio = 5.07, p = 0.02), hypertension (odds ratio = 4.53, p = 0.001), diabetes (odds ratio = 4.53, p = 0.001) and C-reactive protein levels (odds ratio per 1 mg/dl = 1.31, p = 0.02) were the most significant baseline bio-clinical predictors of CVD. Furthermore, an increased education level and greater adherence to the Mediterranean diet (among 35–65-year-old individuals) were associated with a lower CVD incidence (odds ratio per 3 years of school difference = 0.83, p < 0.001 and odds ratio per 1/55 units in diet score = 0.94, p < 0.001), irrespective of various potential confounders. In conclusion, aging, central fat, hypertension and diabetes, inflammation process, low social status and abstinence from a Mediterranean diet seem to predict CVD events within a 5-year period.

Key Words: cardiovascular • diet • education • epidemiology • hypercholesterolemia • incidence • inflammation

Vascular Medicine, Vol. 13, No. 2, 113-121 (2008)
DOI: 10.1177/1358863x07087731


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