Cardiovascular risk assessment in general population with the national health service: The SPICES French first step.

Delphine Le Goff, Michele Odorico, Gabriel Perraud, Paul Aujoulat, Jeremy Deriennic, Marie Barais, Jean-Yves Le Reste

Keywords: cardiovascular diseases, primary prevention, risk assessment

In 2015, cardiovascular diseases (CVD) caused 31% of worldwide deaths. SPICES is an international non-pharmacological primary prevention implementation study involving five countries. In France, the study is implemented in a rural, deprived, medically underserved territory with a cardiovascular increased mortality. The first step of the study was an assessment of CVD risk of individuals in general population in sport events, cultural events, and public places of the territory. Number of possible assessments, relevance of this type of assessment and quality of such a recruitment were uncertain.

Research questions:
Following the Non-Laboratory Interheart risk score (NL-IHRS), what are the characteristics of the individuals undergoing CVD risk assessment for SPICES?

A cross-sectional descriptive study was undertaken. The NL-IHRS was completed on a voluntary basis. Students doing their national health service canvassed people attending to the events. Age, gender, familial history of heart attack, diabetes, hypertension, smoking status, physical activities, dietary habits, psychosocial factors, and abdominal obesity were evaluated. No blood sample was required to achieve NL-IHRS.

From April 15th to September 14th, 2019, 3374 assessments were undertaken in 64 different places. 1582 individuals were at low CVD risk, 1304 at moderate risk, 488 at high risk. The population consisted of 38% of men, 62% of women. Mean age was 54. 18,9% were current smokers, 4,3% diabetics, 18,9% hypertensive. Stressed or depressed individuals were remarkably numerous (39,8% and 24,4% of the population).

An original recruitment was decided to preserve ambulatory care. Levels of diabetics and smokers were comparable to the French population, hypertensive and physical inactive were lower. Feminine population was overrepresented as in general practice studies. Levels of stress and depression lead to an adaptation of the SPICES second phase. Qualitative studies on barriers and facilitators to this risk assessment are ongoing.

Points for discussion:
correlation between NL-IHRS levels and risk assessment location,

methods to recruit male volunteers,

current validated stress interventions.