An evolving pattern of cardiovascular risk in 14,315 men and women attending a nurse-led, cardiac profiling and prevention clinic over a quarter of a century
Bibliographic record
Abstract
Purpose: The burden of cardiovascular disease continues to evolve as the demographic and risk factor profile of affected populations changes over time. In order to document potentially important changes in primary prevention efforts in this regard, we examined the risk profile of >14,000 first time attendees to a nurse-led, cardiac profiling and prevention clinic over a 25-year period. Methods: Routine demographic and clinical data were collected, in a standardised manner, in 7815 men and 6500 women who visited the free and open public access clinic (located in a cardiology unit of a major tertiary hospital) during the period June 1986 to December 2011. Data were compared on a sex-specific basis according to five-yearly historical periods (1986-1991 [P1 - initial 6 months included], 1992-1996 [P2], 1997-2001 [P3], 2002-2006 [P4], 2007-2011 [P5]). Results: Overall, the age profile of men (45.2±14.9 vs. 53.2±14.6 years) and women (45.8±15.5 vs. 52.4±14.3 years) attending the clinic was similar but progressively older over time (P1 vs. P5). In men, average blood pressure (BP) reached a peak during P3 (135±18/84±11 vs. 131±16/83±10 mmHg in P1) before declining in P4/P5 and in women peaked during P4 (137±21/80±11 vs. 126±19/79±11mmHg in P1); p<0.001 for all comparisions. Men and women with elevated BP (≥140/90mmHg) peaked in P2 (46.6%) and in P4 (45%), respectively, but declined overall (39.5% to 31.7% and 28.2% to 24% for P1 vs. P5, respectively); p<0.001. In women there were only small changes in average lipid levels, while in men there was an overall fall from P1 to P5 (5.4±1.1 vs. 5.0±1.2 mmol/L; p<0.001). Men and women with elevated lipid levels (total cholesterol ≥5.5mmol/L) generally declined over time (41.8% to 30.8% and 40.3% to 32.1% for P1 vs. P5, respectively); p<0.001. The proportion of current male smokers initially declined (from 14.3% to 11.2% in P3) before rising again (14.4% in P5) and in women progressively declined from 13.3% to 10.4% (P1 to P5; p<0.001). Throughout the study period (P1 to P5) both men (79.1±11.8 vs. 84.7±15.7 kg) and women (63.6±11.1 vs. 70.7±15.6 kg) became progressively heavier; p<0.001. Fasting blood glucose levels peaked in P3 for both men and women (∼0.5mmol/L more than P1) before also declining towards P1 levels in P4/P5. Conclusions: Over 25 years or more of clinical experience, men and women being profiled for the prevention of cardiovascular disease via a nurse-led clinic have become older and heavier. Consistent with population trends, historical highs in BP and lipid levels have now passed, but risk levels (particularly metabolic-related) remain high.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".