الفهرس 
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Abstract
The present study aimed at determining modifiable and non- modifiable risk factors of CVDs that might lead to CABG surgery.
Methodology:
A hospital-based cross-sectional study had been conducted in Assiut University Heart Hospital, Assiut University, Assiut Governorate. The study was conducted from 1st April 2022 to 31st March 2023.
The study included 210 patients who seek care at the cardiothoracic outpatient clinic or were admitted to the internal ward. All patients who underwent CABG surgery and accepted to participate were included in the study. Patients who refused to participate or sought medical care for reason other than CABG surgery was excluded from the study.
Data collection was conducted using the STEPS instrument questionnaire. It covers three different sections of risk factor assessment:
• The first section included:
-Sociodemographic factors include (age, gender, residency, education, and marital status).
- Behavioral risk factors such (alcohol and tobacco usage, fruit and vegetable consumption, and physical activity).
• The second section included:
- Participants’ physical measurement, including height, weight, and blood pressure.
• The third section included:
- Biochemical measurements, such as high density lipoproteins (HDL), cholesterol, blood lipids, triglycerides, blood glucose, and urine sodium and creatinine.
Results:
Total patients included in the study were (210), Seventy-four percent of the study participants were elderly, with a mean age of 65.8 ± 8.31. sixty percent of the patients were male. More than fifty percent of them lived in rural areas. Those with college or university degrees made up about half of the study population. The percentage of patients who currently smoke tobacco products was (39.5%).
Raised blood pressure was the most common cardiovascular risk factor among study participants, accounting for 93.3% of the population. Seventy-one percent (77.1%) of the study participants did not engage in sufficient physical activity. Almost 70% of the participants in the study were overweight. On average, fewer than half of the study participants (44.8%) consumed fewer than five servings of fruits and/or vegetables daily.
In each patient included in the study, three cardiovascular risk factors were present in almost one-third (33.8%) of the patients. Moreover, about one-third (29.5%) of the study participants had four cardiovascular risk factors.
Regarding the distribution of patients by gender in relation to their dietary habits, it was noted that male patients consumed a mean of 1.7±0.5 servings of fruit per day, which was significantly more than of female patients (1.5±0.5) (p= 0.016). On the other hand, the mean number of days vegetables consumed per week in male patients was significantly lower than in female patients (5.0±0.5 vs. 5.3±0.8 respectively) (p= 0.002). Moreover, there is a statistically significant difference between male patients and female patients regarding adding salt or salty sauce to their food either before or during eating (40.4% vs 59.6%) (p=0.001). Additionally, compared to female patients, a significantly lower percentage of male patients consumed processed foods that were high in salt (p=0.012). The percentage of patients who perform vigorous activity at work was significantly less among male patients 35.4% than female patients 64.6% (p= 0.0001). However, the mean duration of vigorous activity per day and moderate activity per day were significantly higher in male patients (17.7±2.7, 25.5±13.8) than in female patients (10.0±2.5, 20.8±15.8) (p= 0.0001).
It was found that the percentage of those who do vigorous activity and moderate activity at work was significantly less among patients aged less than 60 years (39.6, 37.2 respectively) than patients aged 60 years or more (60.4, 62.8 respectively) (p= 0.043, 0.001 respectively). However, the mean duration of moderate activity per week (day) was significantly higher in less than 60 years than in 60 years or more (2.9±1.1, 2.4±1.1 respectively) (P= 0.002).
The percentage of those who walk or use a bicycle was significantly less among less than 60 years compared to those 60 years or more (22.2%, 77.8% respectively) (p= 0.002). Moreover, the percentage of those who do vigorous sports was significantly less among those less than 60 years than patients aged 60 years or more (15.8%, 84.2% respectively) (p= 0.006).
Out of all the cardiovascular risk factors indicated, the most common ones were eating fewer than five servings of fruit and/or vegetables on a daily average, insufficient physical activity, being overweight (BMI ≥ 25 kg/m2) and having elevated blood pressure representing (22.9%) of all reported risk factors. Moreover, insufficient physical activity, being overweight (BMI ≥ 25 kg/m2) and having elevated blood pressure representing (19.5%) among all study patients.
A significant association between age and frequency of cardiovascular risk factors. The percentage of those having less than 3 cardiovascular risk factors was significantly higher in less than 60 years than in 60 years or more patients (55.6%, 44.4% respectively) (p= 0.0001). While The percentage of those having 3 cardiovascular risk factors or more was significantly higher in 60 years or more patients than in less than 60 years (84.4%, 15.6% respectively) (p= 0.0001).
A significant positive correlation was found between BMI and SBP, DBP and fasting blood sugar (r =0.935, 0.877, 0.608) (p= 0.0001). There was a positive significant correlation between BMI and fasting blood sugar, systolic and diastolic blood pressure in both males (r = 0.255,0.999,0.952 respectively) and females (r = 0.988, 0.966, 0.871 respectively) (P<0.005).
Recommendations:
• Health education programs that raise knowledge about cardiovascular risk factors as well as encourage patients to follow their treatment regimens and take care of themselves.
• Patients with cardiovascular risk factors are recommended to be trained regarding healthy lifestyle behaviors as they are crucial for achieving optimal cardiovascular health.
• Prevention strategies can play a significant role in lowering patient morbidity and mortality.
• Further studies are suggested to evaluate the effects of cardiovascular risk factors in a larger number among patients undergoing CABG surgery.