Document Detail


High cardiovascular risk and poor adherence to guidelines in 11,069 patients of middle age and older in primary care centres.
MedLine Citation:
PMID:  20389248     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Evaluation of the risk for fatal cardiovascular (CV) disease and adherence to guidelines in ambulatory patients in primary care centres.
DESIGN AND METHODS: Cross-sectional survey of risk factors and 10-year Systematic Coronary Risk Evaluation (SCORE) risk in 11,069 patients aged 50 years or more in primary care.
RESULTS: Three-thousand, seven hundred and thirteen (33.5%) patients were actual smokers. Although 61% of the patients were treated with at least one antihypertensive drug, the mean systolic blood pressure was 141±15 mmHg. Of the treated patients, only 15.9% were at goal. Thirty-six percent of the patients were perceived as normocholesterolemic by the primary care physician. In the group of patients, presumed as hypercholesterolemic, the total cholesterol level was 235±38 mg/dl, suggesting that only very high cholesterol level was considered relevant by physicians. Virtually 0% of the patients (n=2) were treated correctly. Obesity (body mass index >30 kg/m) was found in 41% of the patients and central obesity was found in 50% of the patients. Diabetes was present in 2085 (19%) patients and at least one earlier vascular event was present in 2913 (26.3%) patients, with combined pathologies in 388 (4.5%) patients. In the remaining 6766 (61%) patients (neither diabetes nor earlier CV event), the 10-year fatal CV risk according to the Belgian SCORE table was calculated as follows: 716 (10.6%) patients had a risk of less than 2%; 1680 (24.8%) patients had a risk of 2-4%; 2576 (38%) patients had a risk of 5-9% and 1794 (26.6%) patients had a risk of 10% or more.
CONCLUSION: Despite simple, clear, credible guidelines, despite the existence of a simple tool such as SCORE risk scoring and despite a very accessible health system in Belgium, the CV risk remains very high even in a professional medical environment of daily primary care practice.
Authors:
Luc Missault; Nadine Witters; Johan Imschoot
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology     Volume:  17     ISSN:  1741-8275     ISO Abbreviation:  Eur J Cardiovasc Prev Rehabil     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101192000     Medline TA:  Eur J Cardiovasc Prev Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  593-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, St Jan Hospital, Bruges, Belgium. luc.missault@azbrugge.be
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MeSH Terms
Descriptor/Qualifier:
Aged
Ambulatory Care
Anticholesteremic Agents / therapeutic use
Antihypertensive Agents / therapeutic use
Belgium
Cardiovascular Diseases / etiology,  mortality,  prevention & control*
Chi-Square Distribution
Cross-Sectional Studies
Drug Utilization
Female
Guideline Adherence* / statistics & numerical data
Health Care Surveys
Humans
Male
Middle Aged
Physician's Practice Patterns* / statistics & numerical data
Platelet Aggregation Inhibitors / therapeutic use
Practice Guidelines as Topic*
Preventive Health Services* / statistics & numerical data
Primary Health Care* / statistics & numerical data
Risk Assessment
Risk Factors
Smoking Cessation
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Antihypertensive Agents; 0/Platelet Aggregation Inhibitors

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