Worsening Trends in Modifiable Cardiovascular Risk Factors Among Patients Hospitalised for Cardiovascular Disease in Spain (2007-2022): A Nationwide Sex-Specific Analysis.

Aims

To assess sex-specific temporal changes in prevalence of cardiovascular risk factors (CVRF) in patients admitted for cardiovascular diseases (CVD) in Spain from 2007 to 2022.

Methods

A retrospective, population-based analysis using the Spanish Minimum Basic Data Set, including all adults (≥18 years) hospitalised with a principal diagnosis of CVD was performed. Analyses focused on acute myocardial infarction (STEMI, NSTEMI), stroke, heart failure (HF), and aortic stenosis (AS). Temporal trends in the prevalence of the CVRF throughout the study period, for CVD in general and for each specific CVD, both in the overall sample and in men and women, were studied using the join-point jump regression method.

Results

There were 6,734,967 hospital admissions for CVD, 3,776,811 (56.1%) in men and 2,958,156 (43.9%) in women. Women were older (79; IQR: 70-86 vs. 72; IQR 61-81 years; p<0,001). Hypertension was present in the 43.8%, dyslipidaemia in the 36.9% and diabetes mellitus in the 32% of episodes, without differences clinically relevant between women and men. However, smoking habit (19.8%) and alcohol consumption (4%) were significantly and clinically relevant more frequent in men (29.5% vs 7.5% and 6.6% vs 0.6%, respectively), and obesity (11.5%) in women (13.7% vs 9.8%). Over time, prevalence of most CVRF increased in both sexes, except for hypertension, which declined in both. Notably, particularly concerning increases in obesity, dyslipidaemia and smoking were observed among women.

Conclusions

Our results underscore persistent sex-specific differences in the prevalence of CVRF over time throughout the study period in Spain. Men consistently exhibited higher rates of smoking and alcohol consumption, while the prevalence of obesity and hypertension was higher in women.