Gómez Cerezo Jorge Francisco
Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
Med Clin (Barc). 2009 Sep;132 Suppl 2:44-6. doi: 10.1016/S0025-7753(09)71754-3.
The REACH registry allows the degree of control of risk factors associated with atherothrombosis to be evaluated. Although 90% were taking at least one antihypertensive agent, hypertension was controlled in only 42.9% of the patients with vascular disease. This inadequate control may have multiple causes but the main factors are probably clinical inertia, lack of treatment adherence and the absence of combination therapies. Among patients with vascular disease, the percentage of those with good diabetes mellitus control was acceptable. The proportion of subjects with healthy cholesterol levels was suboptimal, even though 71.3% were receiving statins. The percentage of active smokers was 12% in the group of patients with vascular disease. More than 80% of the total population was taking at least one antiplatelet agent. Although the use of these agents is widespread in secondary prevention and that of lipid-lowering drugs is increasing, blood pressure and cholesterol goals are not being achieved in most patients with established vascular disease. In the REACH study, a substantial percentage of patients are not achieving adequate control of cardiovascular risk factors and are not receiving the treatments recommended in clinical practice guidelines.
REACH注册研究能够对与动脉粥样硬化血栓形成相关的危险因素的控制程度进行评估。尽管90%的患者至少服用了一种抗高血压药物，但在血管疾病患者中，仅有42.9%的患者高血压得到控制。这种控制不充分可能有多种原因，但主要因素可能是临床惰性、缺乏治疗依从性以及缺乏联合治疗。在血管疾病患者中，糖尿病控制良好的患者比例是可以接受的。尽管71.3%的患者正在接受他汀类药物治疗，但胆固醇水平正常的受试者比例仍不理想。在血管疾病患者组中，当前吸烟者的比例为12%。超过80%的总人口至少服用了一种抗血小板药物。尽管这些药物在二级预防中的使用很广泛，且降脂药物的使用也在增加，但大多数已确诊血管疾病的患者并未达到血压和胆固醇目标。在REACH研究中，相当比例的患者未能充分控制心血管危险因素，也未接受临床实践指南中推荐的治疗。
