Adherence to cardiovascular prevention principles in subjects at high risk

Czech version

Authors: Otto Mayer Jr. ^1,2; Jan Bruthans ^1,3; Julius Gelžinský ¹; Markéta Mateřánková ¹; Štěpán Mareš ¹; Veronika Svobodová ¹; Jitka Seidlerová ^1,2; Renata Cífková ³; Jan Filipovský ^1,2
Authors‘ workplace: II. interní klinika LF UK a FN Plzeň ¹; Biomedicínské centrum LF UK a FN Plzeň ²; Centrum kardiovaskulární prevence 1. LF UK a Thomayerovy nemocnice Praha ³
Published in: Vnitř Lék 2020; 66(3): 53-60
Category: Original Contributions

Overview

Background: Asymptomatic high-risk individuals represent one of the highest priorities of cardiovascular prevention, in clinical practice frequently overlooked. We analyzed the real adherence to recommended principles of cardiovascular prevention in primary care subjects.

Methods: Our analysis is based on random general population sample, examined in the frame of post-MONICA survey in 2016/17. Each subject was categorized with regard to its individual cardiovascular risk (based on Sixth Joint European Guidelines) and the real adherence to recommended targets was ascertained.

Results: In total 898 subjects aged 25–75 years (47% males) were analyzed. Of them, 16.7% were classified into “very high risk“ and 36.8% into “high risk“ subgroup; remaining 46.5% were only at moderate or low risk. Regarding adherence to recommended principles, in “very high risk“ category only 58.7% abstain from any form of tobacco, 38% reported appropriate physical activity (≥150 minutes of at least moderate activity weekly), 16.7% had recommended body constitution (BMI 20–25 kg/m2 ), 39.3% appropriate blood pressure (<140/90mm Hg) and only 8.7% reached LDL target (<1.8mmol/l). In “high risk” category was the adherence to these targets as follows: 83.9% (tobacco abstinence), 32.7% (physical activity), 17% (body constitution), 58.2% (blood pressure) and 30.8 % (LDL < 2.5 mmol/l). More acceptable was in both risk categories the therapeutic control of glucose metabolism (HbA1c < 53 mmol/mol in diabetics), i.e. 75% and 81%, respectively.

Conclusions: Global adherence of high-risk subjects to recommended principles of cardiovascular prevention is in primary care far from being optimal, notably in “very high risk“ category.

Keywords:

guidelines – general population – Primary care – risk factors – SCORE – treatment target

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