Cardiovascular and stroke disease risk among doctors: a cross-sectional study

The 10-year cardiovascular risk of physicians estimated by the Thai CV risk score and its association with current coronary artery disease: A retrospective study

Background and Aims

To assess the 10-year cardiovascular disease (CVD) risk among Thai physicians. The risk compared to the general population and their relationship with the current coronary artery disease (CAD) were also examined.

Methods

This retrospective study collected data of Thai physicians who underwent cardiovascular assessments between February 14, 2022, and October 31, 2022. The CVD risk was calculated using the Thai CVD risk (TCVR) score, which incorporated variables of age, gender, smoking, diabetes mellitus, blood pressure, and total cholesterol. Additional collected data included family history of CAD, weekly work hours, fiber diet, exercise, body mass index, coronary artery calcium (CAC) score, and presence of CAD. The association between the risk levels with presence of CAD and clinical features including CAC score were analyzed.

Results

Of 1225 physicians, the risk for CVD development was categorized as low in 80.0%, moderate in 11.2%, high in 4.9%, and very high in 3.9%. Among these, 33.6% were found to have higher relative risk compared to the general population of the same age and gender. The overall prevalence of CAD was 11.2%. This prevalence was escalated by risk or relative risk groups: 4.9% in low-, 33.8% in moderate-, 35.1% in high-, and 46.8% in very high-risk groups or 7.2% in lower risk, 8.0% the same risk, and 18.4% higher relative risk groups.

Conclusions

Approximately, 20% of Thai physicians in the study exhibited a moderate to very high 10-year risk of CVD. Furthermore, 33.6% of the physicians had higher risk than individuals of the same age and gender in the general population. The prevalence of CAD increased with higher CVD risk and higher relative risk.

Coronary artery disease and other cardiovascular disorders among the physicians

BACKGROUND

To evaluate the prevalence of cardiovascular disorders (CVDs), specifically coronary artery disease (CAD), among Thai physicians, and the cardiac testing being used. The associated or risk factors of CAD were also studied.

METHODS

Data of Thai physicians who participated in the hospital's corporate social responsibility "Save Doctors' Heart" project conducted between February 14, 2022, and October 31, 2022, were collected: personal illness, family history of CAD, workplace, work hours, dietary habits, exercise, stress, body mass index, laboratory and cardiac testing.

RESULTS

Of 1231 physicians, the median age was 48.0 ± 10.34 years, with 55.2% were female; 83.1% reported working <55 h per week, 29.7% exercised ≥3 days a week, and 28.0% were overweight or obese. Hypertension, diabetes mellitus, and dyslipidemia were found in 46.3%, 30.5%, and 75.8%, respectively. Abnormal findings were observed in 29.7% of chest X-rays, 17.7% of electrocardiograms, 33.0% of echocardiograms, 10.6% of exercise stress tests, and 3.8% of stress echocardiograms. Moderate/extensive coronary artery calcium (CAC) scores were present in 12.7%. The prevalence of CVDs or CAD were 51.7% and 11.2%, respectively. Independent risk factors for CAD included older age, male gender, history and/or new findings of DM, and moderate to extensive CAC scores.

CONCLUSION

The prevalence of CVDs and CAD among Thai physicians is 51.7% and 11.2%, respectively. The independent risk for CAD was older age, male, having DM, and moderate to extensive CAC scores. The physicians who are at risk should be cautious, modify their lifestyle, and have appropriate screening/diagnostic testing for cardiac abnormality.

Association of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio and Coronary Artery Disease Among the Physicians

Introduction

Cardiovascular diseases (CVDs) are major global health problem and are the third leading cause of death in the world. Most studies found the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were correlated with myocardial infarction and heart failure. Previous studies reported a higher risk of CVD among physicians but no study concerns NLR and the PLR to predict coronary artery disease (CAD) among the physicians.

Purpose

This study aimed to evaluate the role of blood features in the CBC, with a particular focus on NLR and PLR levels, in predicting the presence of CAD.

Patients and Methods

Data of Thai physicians who participated in the "Save Doctors' Heart" project which was conducted between February 14 and October 31, 2022, were collected from personal information, work and health habits, physical examination, white blood cell (WBC), laboratory, cardiac testing, and presence of CAD. Prior to studying their association with CAD, optimal values of age and each blood parameter, NLR, and PLR were determined.

Results

Of 1161 physicians mean age was 47.7 ± 10.16 years. By cardiac tests, CAD was identified in 11.3%. Significantly higher levels of WBC, neutrophils, NLR, and lower platelets were found in physicians with CAD. Except for lymphocytes and platelets which exhibited a reverse association with CAD, other factors were found as significant risk factors for CAD by univariate analysis. By multivariate analysis, the independent risk factors for CAD in order of their adjusted odds ratio (aOR) were age ≥50 years (aOR 9.34), NLR ≥ 1.87 (aOR 2.75), CAC score > 1 (aOR 2.39), and PLR ≥ 161.66 (aOR 2.32).

Conclusion

NLR and PLR, older age and CAC score were found as independent factors predicting CAD. The findings of this study could potentially provide valuable insights into the relationship between blood parameters and CAD risk among physicians.

Obesity Burden and Physical Activity Pattern Among Doctors in South India

Context

A career as a doctor makes him prone to develop health issues like obesity and obesity-related noncommunicable diseases.

Aims

This study aims to find the burden and determinants of obesity among Modern Medicine doctors in Kerala.

Settings and Design

We conducted a cross-sectional study among 240 doctors working in South Kerala from 2018 to 2019.

Methods and Material

The sample size was calculated using a formula and stratified random sampling was done for the selection of study participants. An interviewer-administered structured questionnaire was used for data collection. Physical activity was measured using International Physical Activity Questionnaire.

Statistical Analysis

Data were entered in MS Excel and was analyzed using Statistical Package for Social Sciences version 26.0. The significance of association was tested using the χ2 test. Binary logistic regression was done to predict the factors associated with overweight and obesity.

Results

Out of 240 study participants, 128 (54%) were females and 112 (46%) were males. Among the 240 doctors, 54% (114) were either overweight or obese. A low level of physical activity was reported among 54.5% of doctors. Male gender odds ratio (OR) = 2.8 (95% confidence interval [CI] = 1.29-6.06), nuclear family OR = 2.7 (95% CI = 1.32-5.42), daily hours of sleep <6 hours OR = 4.92 (95% CI = 2.29-10.5), history of obesity among parents OR = 3.54 (95% CI = 1.04-12.02), reported the presence of private practice OR = 3.34 (95% CI = 1.25-8.96), and holding a graduation degree alone were found to be significantly associated with obesity.

Conclusions

The study found that majority of the doctors (55%) were either overweight or obese. Awareness and behavior change communication among doctors on modifiable risk factors like having adequate sleep and reducing the hours spent in private practice is needed to reduce the burden of obesity among doctors.

Knowledge, Attitude and Health Practice towards Cardiovascular disease in Health care providers: A Systematic Review

The prevalence of cardiovascular disorders among healthcare providers have been increasing in the past few years and research conducted in this aspect have identified various risk factors that affect cardiovascular health: like shift work, high stress, anxiety, work environment, obesity, high basal metabolic index, and others. PRISMA guidelines were followed and data search was conducted on PubMed, PMC, MEDLINE, and Google Scholar wherein the identification and screening led to 31 selected studies on identification of knowledge, perception and attitude of the healthcare providers regarding their cardiovascular disorders. Results reveal that knowledge level even although high in healthcare providers regarding their cardiovascular health, the attitude or perception differs among them. Lack of time, stigma, fear of unknown, access to healthcare, not wishing to burden co-workers are some of the identified factors which are affecting their decision making regarding proper actions to be taken to address their cardiovascular issues.

Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis

BACKGROUND

Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians.

METHODS

PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex.

RESULTS

Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence.

CONCLUSION

Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.