Rato Quitéria, Cardoso António Almada
Serviço de Cardiologia, Centro Hospitalar de Seútbal, EPE, Hospital de São Bernardo, Setúbal, Portugal.
Rev Port Cardiol. 2006 Oct;25(10):889-905.
"Retrospective Review of the Medical Records of Cardiology Hospital Outpatient Clinics with the Aim of Determining the Therapeutic Approach to Patients Suffering from High Blood Pressure and/or Dyslipidemia" is a pilot study conducted by the Epidemiology and Cardiovascular Prevention Working Group of the Portuguese Society of Cardiology, based on the idea that all patients suffering from high blood pressure and/or dyslipidemia should be treated according to the guidelines for the treatment of these pathologies.
The main aim was to obtain data on the therapeutic approaches to patients observed in cardiology hospital outpatient clinics with high blood pressure and/or dyslipidemia as well as other concomitant diseases, in order to plan future wider-ranging studies and to analyze the main risk factors of cardiovascular conditions in this population.
Patients of both sexes aged 35 years or over were included, diagnosed at least one year previously with high blood pressure and/or dyslipidemia and observed on a regular basis at outpatient clinics, with data being recorded from the consultation after the start of the survey and from consultations in the previous 12 to 18 months.
The survey covered 22 centers, and included 285 patients, 58.4% male and 41.6% female. Of these patients, 87.7% had high blood pressure, 75.8% had dyslipidemia and 63.5 % had both pathologies; the prevalence of diabetes was high and that of coronary disease was very high. The mean body mass index (BMI) at the first observation was 28.7 +/- 4.4, while under 20% of the patients had normal BMI. Sixty-two patients were ex-smokers, and 24 still smoked. Mean systolic blood pressure (BP) was over 140 mmHg in all cases, and diastolic BP was around 80 mmHg. Mean LDL cholesterol remained at around 130 mg/dl and HDL cholesterol at around 50 mg/dl. Almost all patients were under combined therapy with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, calcium channel blockers and statins, with most of these drug classes being prescribed with increasing frequency.
Although this was a high-risk population for cardiovascular conditions, control of blood pressure and of total and LDL cholesterol was in many cases inadequate, exceeding the values recommended in guidelines. Patients were usually polymedicated, with most drug classes, especially statins, being prescribed with increasing frequency.
