141 Cardiovascular risk factors by educational level in CHD patients: SURF CHD II 6 We registered SURF-CHD II center-level information, including the type of center (public or private) and location (urban or rural area). Routine patient data were collected on age, sex, ethnicity, educational level, and diagnostic category. Ethnicity was classified as Arab, Asian, Black, Mixed, White, or other. Educational level was defined as the highest level achieved by participants and grouped as primary vs. secondary or tertiary education (including bachelor’s degree or higher technical certificate). Diagnostic category included stable SAP, ACS, PCI and CABG. Information on risk factor history included admission in the hospital for a CHD-related reason in the past year, smoking history, known history of hypertension, dyslipidemia, or diabetes. The survey included questions on whether patients had participated in a cardiac rehabilitation program, and if they were using the following medications: antiplatelet drugs, beta-blockers, ACE-inhibitors, ARBs, Ca antagonists, other antihypertensives, diuretics, statins, Pcsk9-inhibitors, other lipid-lowering medications, insulin, other hypoglycemics, or nitrates. Information on height and risk factor measurements performed up to three months prior to the visit, including systolic blood pressure, diastolic blood pressure, heart rate, height, weight, and waist circumference, were collected. The following fasting blood values from up to a year before the visit were registered: total cholesterol, LDL, HDL, triglycerides, glucose and Hba1c in diabetics. Outcomes Recording was defined as information available from interview, medical records or laboratory results during the visit following the routine procedures. Given that one of the goals of the study is to assess risk factor recording in daily practice, health professionals were asked not to perform additional measurements outside routine care for the purpose of the survey. If a value was missing, marked “unknown” or not available in the original data source, we considered it not to be recorded. Risk factor targets were defined according to European Society of Cardiology (ESC) clinical guidelines (4,5) (Table 1). Treatment outcomes were defined as self-reported use of antiplatelet medication, antihypertensives (beta-blockers, ACE-inhibitors, ARBs, Ca antagonists, other antihypertensives), lipid-lowering medication (statins, Pcsk9-inhibitors, other lipid-lowering medications), insulin, oral hypoglycemics, and participation to cardiac rehabilitation. Data analysis Categorical variables were presented as percentage of participants, and numerical variables as mean (standard deviation). We calculated the proportion of participants with recorded risk factor information, meeting risk factor targets, using medication and participating in cardiac rehabilitation treatment by educational level. We tested potential differences in risk factor recording, target attainment and medication use in patients with primary education compared with those with secondary or tertiary education using logistic regression adjusted by age and sex. Results are presented as odds ratios and 95% confidence intervals.
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