Perceived and actual cardiovascular disease risk factors, and the obstacles to reduce them, among a representative sample of the current and future medical profession in Malta

Abstract

Background The aim of this study was to quantify the actual and perceived cardiovascular risk among medical students, community and hospital physicians in Malta and to study the cues and reasons for action. The objectives were to study the cues and reasons for action in medical students and doctors that could influence the adoption of less or more healthy lifestyles among medical health professionals, to identify the obstacles in the current and future medical health professionals' own cardiovascular disease risk reduction, to measure the prevalence of physical activity, tobacco consumption and body mass index among a representative sample of Maltese current and future health professionals and to assess and compare the current true and perceived risks for cardiovascular disease among current and future Maltese health professionals.

Research Design and Methods 150 subjects were invited to take part in this study. They were randomly selected from the whole list of practicing Maltese physicians and of medical students. There were 60 hospital doctors, 60 community doctors and 30 medical students. The participants replied to a questionnaire regarding their perceived risk for cardiovascular disease. Blood pressure, body mass index and their waist and hip were measured. The subjects also had their blood tested for a lipid profile and blood glucose. The European SCORE (Systematic Coronary Risk Evaluation) risk charts were used to calculate the 10 year risk of fatal cardiovascular disease.Results A response rate of 71 % was achieved in this study. 46 hospital doctors, 39 community doctors and 21 medical students took part. 42.5% of the participants were females while 57.5% were males. The total prevalence of tobacco smoking was found to be 4.7%. 35.8% of the participants reported themselves as leading a sedentary lifestyle.

More than half of all participants were in the overweight and obese ranges. 14% had a higher than normal blood pressure on examination. Almost 60% of the community doctors were in the moderate and high risk groups of waist to hip ratio, followed by 46% of hospital doctors and almost one third of medical students. Two-thirds of the participants had <1 % SCORE risk of fatal cardiovascular disease in 10 years while almost 2% had >5% risk. There was a statistically significant correlation between the actual and perceived risk of having a fatal cardiovascular event in the next 10 years (p-value 0.014). However there was a statistically significant difference between the actual and perceived levels of blood pressure, total cholesterol and glucose levels. The perceived barriers, benefits and cues to action toward cardiovascular risk were also analysed in the discussion.

Conclusion The agreement between self reported 10 year cardiovascular mortality risk and that using the SCORE charts was good. However, the results suggest that doctors have a myriad of poor risk factor for cardiovascular disease, although tobacco and lack of physical activity do not feature in this. This study also provides food for thought on how doctors feel about giving advice to their patients when they themselves demonstrate poor risk factors.