Is global cardiovascular risk considered in current practice? Treatment and control of hypertension, hyperlipidemia, and diabetes according to patients' risk level

• Published in: Vascular health and risk management 2006-12, Vol.2 (4), p.507-514
• Main Authors: Roccatagliata, Daria, Avanzini, Fausto, Monesi, Lara, Caimi, Vittorio, Lauri, Davide, Longoni, Paolo, Marchioli, Roberto, Tombesi, Massimo, Tognoni, Gianni, Roncaglioni, Maria Carla
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antihypertensive Agents - therapeutic use; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Cross-Sectional Studies; Diabetes; Diabetes Mellitus - drug therapy; Drug Prescriptions - statistics & numerical data; Drug Therapy, Combination; Family Practice - statistics & numerical data; Female; Guideline Adherence; Health risk assessment; Humans; Hyperlipidemia; Hyperlipidemias - complications; Hyperlipidemias - drug therapy; Hypertension; Hypertension - complications; Hypertension - drug therapy; Hypoglycemic Agents - therapeutic use; Hypolipidemic Agents - therapeutic use; Italy - epidemiology; Male; Middle Aged; Original Research; Pilot Projects; Practice Guidelines as Topic; Practice Patterns, Physicians' - statistics & numerical data; Risk Assessment; Risk Factors; Treatment Outcome
• ISSN: 1176-6344; 1178-2048; 1178-2048
• DOI: 10.2147/vhrm.2006.2.4.507

To assess the pharmacological treatment and the control of major modifiable cardiovascular risk factors in everyday practice according to the patients' cardiovascular risk level. In a cross-sectional study general practitioners (GPs) had to identify a random sample of their patients with cardiovascular risk factors or diseases and collect essential data on the pharmacological treatment and control of hypertension, hyperlipidemia, and diabetes according to the patients' cardiovascular risk level and history of cardiovascular disease. Participants were subjects of both sexes, aged 40-80 years, with at least one known cardiovascular risk factor or a history of cardiovascular diseases. From June to December 2000, 162 Italian GPs enrolled 3120 of their patients (2470 hypertensives, 1373 hyperlipidemics, and 604 diabetics). Despite the positive association between the perceived level of global cardiovascular risk and lipid-lowering drug prescriptions in hyperlipidemic subjects (from 26% for lowest risk to 56% for highest risk p < 0.0001) or the prescription of combination therapy in hypertensives (from 41% to 70%, p < 0.0001) and diabetics (from 24% to 43%, p = 0.057), control was still inadequate in 48% of diabetics, 77% of hypertensives, and 85% of hyperlipidemics, with no increase in patients at highest risk. Trends for treatment and control were similar in patients with cardiovascular diseases. Even in high-risk patients, despite a tendency towards more intensive treatment, pharmacological therapy is still under used and the degree of control of blood pressure, cholesterol level and diabetes is largely unsatisfactory.