Hermans Michel P, De Bacquer Dirk, De Block Christophe, Truyers Carla, Vankeirsbilck Annelies, De Backer Guy
Acta Cardiol. 2014 Oct;69(5):473-81. doi: 10.1080/ac.69.5.3044873.
The objective of this study was to evaluate the level of target achievement for key modifiable cardiovascular disease (CVD) risk factors (dyslipidaemia, arterial hypertension, hyperglycaemia, smoking, and physical inactivity) in Belgium.
This non-systematic review of Belgian data from four recent studies assessed the control of CVD risk factors in clinical settings: the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA), the Optimal Type 2 Diabetes Management Including Benchmarking and Standard Treatment Study (OPTIMISE), the European Action on Secondary and Primary Prevention by Intervention to Reduce Events Survey (EUROASPIRE III), and data from a general practice-based morbidity registration network (INTEGO). For each study, target achievement levels were evaluated using the guidelines that were applicable at the time of the study. The overall results show that the main CVD risk factors are poorly controlled in patients with established CVD and in patients at high CVD risk. Therapeutic targets may be incompletely reached because of the suboptimal implementation of European guidelines for CVD prevention in routine clinical practice (insufficient lifestyle and dietary adaptations; poor applications of drug therapy to control blood pressure, dyslipidaemia and hyperglycaemia) or the insufficient efficacy of the currently available treatments options in some patients.
This review provides clear and updated evidence for non-target achievement for all major risk factors, with four different study designs and inclusion criteria, and highlights the need for more comprehensive and intensive application of European guidelines recommendations for CVD prevention in Belgium.
本研究旨在评估比利时主要可改变的心血管疾病(CVD)危险因素(血脂异常、动脉高血压、高血糖、吸烟和身体活动不足)的目标达成水平。
这项对来自四项近期研究的比利时数据的非系统性综述评估了临床环境中CVD危险因素的控制情况:欧洲日常实践中心血管风险预防与管理研究(EURIKA)、包括基准化和标准治疗研究在内的2型糖尿病优化管理研究(OPTIMISE)、通过干预减少事件的二级和一级预防欧洲行动调查(EUROASPIRE III)以及基于全科医疗发病率登记网络(INTEGO)的数据。对于每项研究,使用研究当时适用的指南评估目标达成水平。总体结果表明,在已确诊的CVD患者和CVD高风险患者中,主要CVD危险因素控制不佳。由于欧洲CVD预防指南在常规临床实践中实施欠佳(生活方式和饮食调整不足;药物治疗在控制血压、血脂异常和高血糖方面应用不佳)或某些患者中现有治疗方案疗效不足,治疗目标可能无法完全实现。
本综述通过四种不同的研究设计和纳入标准,为所有主要危险因素未达成目标提供了清晰且最新的证据,并强调在比利时需要更全面、深入地应用欧洲CVD预防指南建议。