Awareness of personal cardiovascular risk among the adults with an elevated body mass index in a very high-risk country
Authors: Petrovic J , Radomirovic M , Petrovic Djordjevic I , Petrovic A , Markovic M , Todorovic J , Santric-Milicevic M , Ivanovic B 
Published: October 2024

Abstract

Background
An elevated body mass index (BMI) is a risk factor for cardiovascular diseases (CVD). The awareness of personal cardiovascular risk (pCVR) may vary in different populations, thus influencing health behaviours and cardiovascular prevention.

Purpose
To analyse the awareness of pCVR among the adults with an elevated BMI, along with sociodemographic characteristics and cardiovascular risk factors (CRF) possibly associated with the lack of pCVR awareness in a very high-risk country.

Methods
The pilot study included a convenient sample of 1054 adults. Those with an elevated BMI (≥25 kg/m2) were divided into two groups depending on their awareness of pCVR. The groups were compared according to the sociodemographic characteristics (age, gender, and education) and CRF (BMI, hypertension, dyslipidaemia, diabetes mellitus, smoking, physical inactivity, feeling of frequent exposure to stress, previous myocardial infarction (MI), and family history for CVD). The data were collected by voluntary filling out a survey with multiple-choice questions from April 1st to June 30th, 2022.

Results
Out of the total number, about half of the participants had an elevated BMI (N=549, 52%). Most of them were aware of their pCVR (69% vs 31%, p&lt;0.01). Those unaware of pCVR were younger (44±13 vs 51±14, p&lt;0.05), mostly females (56% vs 47%, p&lt;0.05), with high education (61% vs 51% with more than high school, p&lt;0.05). The groups had similar average BMI (28±3 kg/m2 vs 29±3 kg/m2, p&gt;0.05), but the participants unaware of pCVR were more frequently overweight than obese (82% vs 64% with BMI ≥25 kg/m2 and &lt;30 kg/m2, p&lt;0.01). They had significantly lower frequencies of hypertension (15% vs 53%, p&lt;0.01), dyslipidaemia (23% vs 46%, p&lt;0.01), diabetes mellitus (2% vs 14%, p&lt;0.01), smoking (50% vs 59%, p&lt;0.05), previous MI (3% vs 26%, p&lt;0.01), and family history for CVD (62% vs 82%, p&lt;0.01). However, the majority in both groups reported physical inactivity (60% vs 64%, p&gt;0.05) and a feeling of frequent stress exposure (70% vs 71%, p&gt;0.05). The participants unaware of pCVR less frequently had over three modifiable CRF (12% vs 37%, p&lt;0.01).

Conclusion
Most of the adults with an elevated BMI in a very high-risk country are aware of pCVR, usually because of obesity, multiple additional modifiable CRF, previous MI, or family history of CVD. Still, a notable proportion of the adults with an elevated BMI in a very high-risk country is unaware of pCVR, which is associated with younger age, female gender, high education, overweight, fewer additional modifiable CRF, and the absence of previous MI or family history for CVD. This subpopulation should be considered as a target for timely health education to raise the awareness of pCVR. Increasing physical activity through motivational campaigns and developing programmes for stress relief would be important for CVD prevention among the adults with an elevated BMI, independently of pCVR awareness.