Comparative risk assessment for the development of cardiovascular diseases in the Hungarian general and Roma population

Abstract

Cardiovascular diseases (CVDs) are the number one cause of death globally, and the early identification of high risk is crucial to prevent the disease and to reduce healthcare costs. Short life expectancy and increased mortality among the Roma are generally accepted (although not indeed proven by mortality analyses) which can be partially explained by the high prevalence of cardiovascular risk factors (CVRF) among them. This study aims to elaborate on the prevalence of the most important CVD risk factors, assess the estimation of a 10-year risk of development of fatal and nonfatal CVDs based on the most used risk assessment scoring models, and to compare the Hungarian general (HG) and Roma (HR) populations. In 2018 a complex health survey was accomplished on the HG (n = 380) and HR (n = 347) populations. The prevalence of CVRS was defined and 10-year cardiovascular risk was estimated for both study populations using the following systems: Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease (FRSCVD), Systematic COronary Risk Evaluation (SCORE), ACC/AHA Pooled Cohort Equations (PCE) and Revised Pooled Cohort Equations (RPCE). After the risk scores had been calculated, the populations were divided into risk categories and all subjects were classified. For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of the gender. The proportion of high-risk group in the Hungarian Roma males population was on average 1.5–3 times higher than in the general one. Among Roma females, the average risk value was higher than in the HG one. The proportion of high-risk group in the Hungarian Roma females population was on average 2–3 times higher compared to the distribution of females in the general population. Our results show that both genders in the Hungarian Roma population have a significantly higher risk for a 10-year development of cardiovascular diseases and dying from them compared to the HG one. Therefore, cardiovascular interventions should be focusing not only on reducing smoking among Roma but on improving health literacy and service provision regarding prevention, early recognition, and treatment of lipid disorders and diabetes among them.

Physical Activity Pattern Characterized by Domains and Dimensions of the Roma Population in Comparison with That of the General Population in Northeast Hungary

“…For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of sex. The proportion of high-risk group in the Hungarian Roma male population was on average 1.5–3 times higher than in the general one, while among Roma females, the proportion of high-risk groups in the Hungarian Roma female population was on average 2–3 times higher compared to the distribution of females in the general population [ 32 ]. By defining the metabolic syndrome (MetS) prevalence by age groups, we could show that MetS arises earlier among the Roma than in the HG population; while there is no significant difference in MetS prevalence between HG and HR populations in the 20–34 years age group (29.6% and 26.4%, respectively), it is significantly higher in the HR population than in the HG population in the 35–49 years age group (46.7% vs. 31.6%), i.e., in comparison with the prevalence values for the age group of 20–34 years, a significant increase in MetS prevalence can be observed in the age group of 35–49 years among Roma, while in case of the HG population, it can be detected only in the older age group (50–64 years) [ 33 ].…”

Changes in the Prevalence of Metabolic Syndrome, Its Components, and Relevant Preventive Medication between 2011 and 2018 in the Northeast Hungarian Roma Population

“…Increased mortality and shorter life expectancy among the Roma are not proven in Hungary (ethnicity is not recorded in the mortality statistics) but can be suspected based on the high prevalence of health risk factors among them. Among the Roma, the frequency of cardiovascular risk factors is higher compared with that among the general population [ 12 , 13 ], and, consequently, their estimated cardiovascular risk is significantly higher, too [ 14 ].…”

The profile of HDL-C subfractions and their association with cardiovascular risk in the Hungarian general and Roma populations

“…The prevalence of cardiovascular risk factors 16 – 20 and, thus, the overall estimated cardiovascular risk are significantly higher among the Roma than the host country average 21 . Previous studies have shown that reduced HDL-C levels are very common in the Roma population 22 – 25 and that the estimated 10-year cardiovascular risk is also significantly higher in the case of both sexes among them than in the Hungarian general population 21 .…”