# Comprehensive evaluation of cardiovascular risk control in a large national cohort: insights from over 1 million participants in a cardiovascular prevention program

## TL;DR

This study analyzed cardiovascular risk factors in over a million people in Poland, revealing significant age and sex differences in conditions like obesity and hypertension.

## Contribution

The study provides new insights into sex- and age-specific disparities in cardiovascular risk factors using a large national cohort.

## Key findings

- Overweight and obesity rates were significantly higher in men compared to women.
- Hypertension and elevated cholesterol were prevalent, with distinct patterns across age and sex groups.
- Undiagnosed diabetes and smoking rates increased with age, particularly among older women.

## Abstract

Cardiovascular diseases (CVDs) remain the leading cause of mortality in Europe, driven by a persistently high prevalence of modifiable risk factors. The aim of this study is to assess the prevalence, age-related trends, and sex differences in cardiovascular risk factors among adults aged 35–65 years participating in the Cardiovascular Prevention Program in Poland (2022–2024).

This cross-sectional study included 1,187,168 adults (718,528 women; 468,640 men) screened as part of Polish Cardiovascular Prevention Program. Evaluated risk factors were hypertension, hypercholesterolemia, elevated fasting glucose, tobacco use, low physical activity, overweight, and obesity. Analyses were stratified by age, sex, and year of participation. Linear and polynomial regression models were used to describe age-related patterns and short-term changes observed over the study period.

Overweight (46.9–47.0% vs. 33.3–34.0%; p < 0.001) and obesity (29.8–30.3% vs. 21.3–22.2%; p <0.001) were notably higher in men. Among women, overweight and obesity nearly doubled with age (p for trend < 0.05). Hypertension was less prevalent than expected but still higher in men (29.8–31.5% vs. 15.8–17.1%; p <0.001). Elevated cholesterol affected 63.5–66.9% of participants, especially women (p <0.001), with no age-related decline (p for trend < 0.05). Undiagnosed diabetes rose with age, reaching 5.1% in men aged 60–65 (p for trend < 0.001). Smoking persisted at high levels across all age groups, increasing among older women (p for trend < 0.05; sex difference p <0.001). Physical inactivity declined with age in women (p for trend < 0.05) but increased in men (p for trend < 0.05).

In a large cohort without cardiovascular disease, we identified alarmingly high levels of modifiable risk factors, with significant age and sex disparities. These findings highlight the urgent need for targeted, sex- and age-specific strategies to reduce cardiovascular risk.