Associations of sociodemographic factors and lifestyle behaviors with the risk of cardiometabolic disease: a population-based study from the European health interview survey in Hungary

社会人口因素和生活方式行为与心血管代谢疾病风险的关联:一项基于匈牙利欧洲健康访谈调查的人群研究

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Abstract

BACKGROUND: Cardiometabolic diseases (CMDs), including cardiovascular diseases (CVD), type 2 diabetes mellitus (T2DM), and metabolic syndrome, are major global health concerns. In Hungary, CVD mortality remains above the OECD average, and diabetes prevalence is increasing. This study examines the association between sociodemographic and lifestyle factors and the risk of CMDs among Hungarian adults, using population-based data collected between 2009 and 2019. METHODS: A repeated cross-sectional design was used to analyze data from the European Health Interview Survey (EHIS) in Hungary for the years 2009, 2014, and 2019 (n = 16,480). CMD was defined as self-reported diagnosis of both CVD and diabetes. Weighted proportions, Pearson's chi-squared tests, and multiple binary logistic regression models were applied to identify associations between CMD and sociodemographic (sex, age, education, employment, income, residence), behavioral (BMI, smoking, alcohol use), and clinical risk factors (hypertension, hypercholesterolemia). Predicted probabilities were estimated using marginal effects. RESULTS: Prevalence of CMD fell by 27% in 2019 (OR = 0.73 [0.57-0.94], P = 0.013), with predicted probability declining from 5.6% to 4.1%. Younger age (< 35: OR = 0.01, P < 0.001; 35-64: OR = 0.68, P = 0.002), female sex (OR = 0.65, P < 0.001), and employment (OR = 0.32, P < 0.001) were protective. CMD risk was higher in urban areas (OR = 1.44, P = 0.048), alcohol users (OR = 1.35, P = 0.004), those with hypertension (OR = 3.83, P < 0.001), hypercholesterolemia (OR = 3.10, P < 0.001), mental illness (OR = 1.49, P = 0.027), and depression (OR = 1.63, P = 0.001). Normal BMI reduced risk (OR = 0.48, P < 0.001). CONCLUSION: The prevalence of CMD in Hungary decreased between 2009 and 2019, indicating progress in prevention and risk factor management. However, disparities persist among older adults, men, and urban residents. Targeted screening, lifestyle interventions, and mental health support are essential to strengthen the management of cardiometabolic diseases.

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