title: Ignorance of cardiovascular preventive measures is associated with all-cause and cardiovascular mortality in the French general population.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the primary cause of premature death in Western countries.
  
  
  OBJECTIVE
  To assess the effect of patient ignorance of CVD risk modifiers on mortality.
  
  
  METHODS
  We studied 4930 men and women in primary prevention, who consulted at the Department of Preventive Cardiology of a university hospital in France from 1995 to 2011. Questionnaires on socioeconomic level, medical history, cardiovascular risk factors, knowledge of CVD, drug intake, lifestyle and dietary recommendations, and adherence to treatments were administered by trained medical staff. Vital status (cause and date of death, in patients who died) was obtained through the French National Database. Multivariable predictive relationships with total mortality were evaluated using the Cox proportional hazards model.
  
  
  RESULTS
  Mean follow-up was 8.6 years; 123 deaths, including 31 cardiovascular deaths, were recorded. Overall, 1305 patients (26%) were ignorant of CVD preventive measures; their mean age (53 years) was similar to that of the non-ignorant population, but most were men with a low educational level, a higher body mass index and significantly more cardiovascular risk factors (diabetes, hypertension). The ignorant group's lifestyle did not conform to cardiovascular guidelines, with less physical activity and more frequent inappropriate diet and smoking. All-cause and cardiovascular mortalities were higher among these patients. In the multivariable analysis, after adjusting for age, sex, smoking status, diabetes, hypertension, body mass index and educational status, ignorance of CVD preventive measures remained significantly associated with all-cause mortality (hazard ratio 1.93, 95% confidence interval 1.31-2.83; P<0.01).
  
  
  CONCLUSIONS
  Ignorance of cardiovascular risk modifiers was significantly associated with all-cause mortality in a general French population.
authors.affiliation: Toulouse University Hospital (CHU), Department of Cardiology, 31059 Toulouse, France; Toulouse University Hospital (CHU), University of Toulouse III, Department of Epidemiology, Health Economics and Public Health, UMR1027 Inserm, 31073 Toulouse, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Séguro
authors.affiliation: Toulouse University Hospital (CHU), Department of Cardiology, 31059 Toulouse, France.
authors.forename: Dorota
authors.initials: D
authors.lastname: Taraszkiewicz
authors.affiliation: Toulouse University Hospital (CHU), University of Toulouse III, Department of Epidemiology, Health Economics and Public Health, UMR1027 Inserm, 31073 Toulouse, France.
authors.forename: Vanina
authors.initials: V
authors.lastname: Bongard
authors.affiliation: Toulouse University Hospital (CHU), University of Toulouse III, Department of Epidemiology, Health Economics and Public Health, UMR1027 Inserm, 31073 Toulouse, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bérard
authors.affiliation: Toulouse University Hospital (CHU), Department of Cardiology, 31059 Toulouse, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Bouisset
authors.affiliation: Toulouse University Hospital (CHU), University of Toulouse III, Department of Epidemiology, Health Economics and Public Health, UMR1027 Inserm, 31073 Toulouse, France.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Ruidavets
authors.affiliation: Toulouse University Hospital (CHU), Department of Cardiology, 31059 Toulouse, France; Toulouse University Hospital (CHU), University of Toulouse III, Department of Epidemiology, Health Economics and Public Health, UMR1027 Inserm, 31073 Toulouse, France. Electronic address: jean.ferrieres@univ-tlse3.fr.
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrières
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011159:Population Surveillance; D011322:Primary Prevention / Q000379:methods*; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
keywords: Algorithme de prédiction du risque; Cardiovascular mortality; Facteurs de risque; Low-risk population; Mortalité cardiovasculaire; Population à bas risque; Risk factors; Risk prediction algorithm