Baena-Díez José Miguel, Félix Francisco Javier, Grau María, Cabrera de León Antonio, Sanz Hector, Leal Manuel, Elosua Roberto, Rodríguez-Pérez María Del Cristo, Guembe María Jesús, Torán Pere, Vega-Alonso Tomás, Ortiz Honorato, Pérez-Castán José Fernando, Frontera-Juan Guillermo, Lapetra José, Tormo María José, Segura Antonio, Fernández-Bergés Daniel, Marrugat Jaume
Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM, Barcelona, España; Centro de Salud La Marina, IDIAP Jordi Gol, Institut Català de la Salut, Barcelona, España.
Rev Esp Cardiol. 2011 Sep;64(9):766-73. doi: 10.1016/j.recesp.2011.04.019. Epub 2011 Jul 20.
The treatment and control of cardiovascular risk factors both play key roles in primary prevention. The aim of the present study is to analyze the proportion of primary prevention patients aged 35-74 years being treated and controlled in relation to their level of coronary risk.
Pooled analysis with individual data from 11 studies conducted in the first decade of the 21st century. We used standardized questionnaires and blood pressure measures, glycohemoglobin and lipid profiles. We defined optimal risk factor control as blood pressure < 140/90 mm Hg and glycohemoglobin <7%. In hypercholesterolemia, we applied both the European Societies and Health Prevention and Promotion Activities Programme criteria.
We enrolled 27 903 participants (54% women). Drug treatments were being administered to 68% of men and 73% of women with a history of hypertension (P<.001), 66% and 69% respectively, of patients with diabetes (P=.03), and 39% and 42% respectively, of those with hypercholesterolemia (P<.001). Control was good in 34% of men and 42% of women with hypertension (P<.001); 65% and 63% respectively, of those with diabetes (P=.626); 2% and 3% respectively, of patients with hypercholesterolemia according to European Societies criteria (P=.092) and 46% and 52% respectively, of those with hypercholesterolemia according to Health Prevention and Promotion Activities Programme criteria (P<.001). The proportion of uncontrolled participants increased with coronary risk (P<.001), except in men with diabetes. Lipid-lowering treatments were more often administered to women with ≥ 10% coronary risk than to men (59% vs. 50%, P = 0,024). [corrected]
The proportion of well-controlled participants was 65% at best. The European Societies criteria for hypercholesterolemia were vaguely reached. Lipid-lowering treatment is not prioritized in patients at high coronary risk.