title: Screening for cardiovascular risk in asymptomatic users of the primary health care network in Lebanon, 2012-2013.
abstract: BACKGROUND
  In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population.
  
  
  METHODS
  A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension.
  
  
  RESULTS
  Approximately 25% of the sample displayed metabolic impairments (11% for impaired blood glucose metabolism and 17% for impaired systolic blood pressure), and 6.6% were classified at total cardiovascular risk of 10% or more. Just over one-quarter of the sample was obese, almost half had a substantially elevated waist circumference, and 41% were smokers. Men were significantly more likely to screen positive for metabolic impairment than women, and women were more likely to be obese.
  
  
  CONCLUSIONS
  The implementation of a multifactorial screening for CVD among asymptomatic subjects detected a substantial proportion of previously undiagnosed cases of high metabolic risk, people who could now be referred to optimal medical follow-up.
authors.affiliation: Centre for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon. E-mail: rouham@gmail.com.
authors.forename: Rouham
authors.initials: R
authors.lastname: Yamout
authors.affiliation: Faculty of Public Health, Lebanese University, Beirut, Lebanon.
authors.forename: Salim M
authors.initials: SM
authors.lastname: Adib
authors.affiliation: Ministry of Public Health, Beirut, Lebanon.
authors.forename: Randa
authors.initials: R
authors.lastname: Hamadeh
authors.affiliation: Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
authors.forename: Alia
authors.initials: A
authors.lastname: Freidi
authors.affiliation: Faculty of Health Sciences, American University of Beirut, and Ministry of Public Health, Beirut, Lebanon.
authors.forename: Walid
authors.initials: W
authors.lastname: Ammar
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011159:Population Surveillance; D011320:Primary Health Care / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D057566:Self Report; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data