Modifable risk factors in adults with and without prior cardiovascular disease: fndings from the Indonesian National Basic Health Research

Backgrounds: The majority of risk factors for cardiovascular diseases (CVDs) are modifable. Continuous monitoring and control of these factors could signifcantly reduce the risk of CVDs-related morbidity and mortality. This study estimated the prevalence of modifable risk factors in Indonesia and its co-occurence of multiple risk factors stratifed by prior CVDs diagnosis status and sex.
Methods: Adult participants (>15 years, N=36,329, 57% women) with median age of 40 years were selected from a nationwide Indonesian cross-sectional study called Basic Health Research or Riset Kesehatan Dasar (Riskesdas) con ducted in 2018. Thirteen risk factors were identifed from the study, including smoking, a high-risk diet, inadequate fruit and vegetable consumption, a low physical activity level, the presence of mental-emotional disorders, obesity, a high waist circumference (WC), a high waist-to-height ratio (WtHR), hypertension, diabetes, a high total cholesterol level, a high low-density lipoprotein (LDL) cholesterol level, and a low high-density lipoprotein (HDL) cholesterol level. Age-adjusted prevalence ratios stratifed by CVDs status and sex were calculated using Poisson regression with the robust covariance estimator.
Results: CVDs were found in 3% of the study population. Risk factor prevalence in the overall population ranged from 5.7 to 96.5% for diabetes and inadequate fruit and vegetable consumption respectively. Smoking, a high-risk food diet, and a low HDL cholesterol level were more prevalent in men, whereas a low physical activity level, the pres ence of mental-emotional disorders, obesity, a high WC, a high WtHR, hypertension, diabetes, a high total choles terol level, and a high LDL cholesterol level were more prevalent in women. Approximately 22% of men and 18% of women had at least 4 risk factors, and these proportions were higher in participants with prior CVDs diagnosis.
Conclusions: There is a high prevalence of modifable risk factors in the Indonesian adult population. Sex, age, and the presence of CVD are major determinants of the variations in risk factors. The presence of multiple risk factors, which are often inter-related, requires a comprehensive approach through health promotion, lifestyle modifcation and patient education.