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The impact of cardiovascular risk reduction on subsequent sickness absence

Session Poster Session III - Friday 08:30 - 12:30

Speaker Carlos Fernandez-Labandera Ramos

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Risk Factors and Prevention
  • Session type : Poster Session

Authors : C Fernandez-Labandera (Madrid,ES), C Catalina-Romero (Madrid,ES), M Cabrera Sierra (Madrid,ES), L Quevedo-Aguado (Madrid,ES), M Ruiz-Moraga (Madrid,ES), LM Ruilope (Madrid,ES), MA Sanchez-Chaparro (Málaga,ES), P Valdivielso (Málaga,ES), A Gonzalez-Quintela (Santiago de Compostela,ES), E Calvo-Bonacho (Madrid,ES)

Authors:
C Fernandez-Labandera1 , C Catalina-Romero1 , M Cabrera Sierra1 , L Quevedo-Aguado1 , M Ruiz-Moraga1 , LM Ruilope2 , MA Sanchez-Chaparro3 , P Valdivielso3 , A Gonzalez-Quintela4 , E Calvo-Bonacho1 , 1Ibermutuamur - Madrid - Spain , 2Doce de Octubre Hospital - Madrid - Spain , 3UGC Medicina Interna. Hospital Universitario “Virgen de la Victoria”. - Málaga - Spain , 4Department of Internal Medicine, University of Santiago de Compostela - Santiago de Compostela - Spain ,

On behalf: This study is funded by FIS, Exp.: PI12/02812. Spanish Ministry of Economy and Competitiveness and Carlos III Health Institute.

Citation:

Purpose: We have recently demonstrated that an increased CV risk promotes a significant increase in length and cost of sick leave episodes. Now we assess the impact of the improvement in cardiovascular risk (CVR) on sickness absence.

Methods: Prospective cohort study of 179,186 workers from the ICARIA (Ibermutuamur Cardiovascular Risk Assessment) study. Workers’ CVR was assessed by the SCORE system in two consecutive years (365 ±90 days). Cardiovascular risk was categorized in low and moderate-to-high and subjects were finally classified in four groups created according to the change or stability between the two measures of their CVR: always low CVR (166,547), worsening in CVR (4,321), improvement in CVR (3,422), and always moderate-to-high CVR (4,896). 1-year follow up was carried out to assess sickness absence. The total count of sickness absence days during 1-year follow-up was the outcome in Poisson regression analysis in order to test the differences in sickness absence among the four groups. Always moderate to high CVR workers were the reference group. Rate Ratios (RR) were adjusted by sex, age, occupation, changes in smoking consumption and previous sickness absence. The improvement in CVR, and always moderate-to-high CVR groups were compared in order to clarify the specific cardiovascular risk factors that improved from the first to the second CVR assessment (chi-squared test).

Results: After adjusting for covariates, the group of workers that improved their CVR showed a reduced count of sickness absence than always moderate-to-high CVR group (RR=0.91, 95%CI: 0.84-0.98). Such decrease was observed when non-work-related (RR=0.89, 95%CI: 0.81-0.96) and cardiovascular diseases (RR=0.66, 95%CI: 0.61-0.71) were considered separately, but not in the case of occupational injuries and work-related diseases (RR=0.96, 95%CI: 0.87-1.05).  The most striking differences between the groups of workers with moderate-to-high CVR improving or not their CVR in the second assessment were lower percentages of smokers (51.3 vs.69.5, p=<0.001) and that of workers with high blood pressure (55.1vs. 81.7, p<0.001) in the group that improved CVR.

Conclusion: The change in CVR level throughout a 1-year period is significantly associated with changes in the subsequent sickness absence. Our results suggest that the improvement in CVR level from moderate-to-high to low CVR is associated with a decrease in sickness absence during the next year. Smoking cessation and better control of blood pressure were the main differences between workers who improved and not improved their moderate-to-high CVR.

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