de Boer Anna W, de Mutsert Renée, den Heijer Martin, Jukema Johan W, Rosendaal Frits R, Blom Jeanet W, Assendelft Willem J J
Department of Clinical Epidemiology and Department of Public Health and Primary Care, Leiden University Medical Center, Leiden,
Department of Clinical Epidemiology and.
Fam Pract. 2015 Dec;32(6):646-51. doi: 10.1093/fampra/cmv080. Epub 2015 Oct 17.
In general practice, it is too time-consuming to invite all patients for cardiovascular risk assessment.
To examine how many patients with an indication for treatment with cardiovascular medication can be identified by ad hoc case-finding when all patients with overweight/obesity are invited for risk assessment.
A cross-sectional analysis of the baseline measurements of the Netherlands Epidemiology of Obesity study, a population-based prospective cohort study in 6673 persons aged 45-65 years. We calculated the proportion of participants with a treatment indication using the risk prediction Systematic COronary Risk Evaluation (SCORE-NL 2011), for lean, overweight and obese participants. Participants with a history of cardiovascular disease, diabetes mellitus or rheumatoid arthritis or using cardiovascular medication were not eligible for ad hoc case-finding because they were already identified as being at risk and/or had been treated.
Of the study population, 30% had already been identified and/or treated with cardiovascular medication and were therefore not eligible for ad hoc case-finding. Of the eligible participants, 47% were lean, 41% overweight and 12% obese. Of the participants with overweight, 12% had a treatment indication and of the participants with obesity, 19% had a treatment indication. Of all participants with a treatment indication 24% were not yet treated. Of all participants with a new treatment indication, 70% had overweight or obesity.
Of the participants with a treatment indication, 24% were not yet treated. Inviting patients with overweight/obesity for cardiovascular risk assessment may help to detect 70% of these residual patients with a treatment indication.
在一般医疗实践中,邀请所有患者进行心血管风险评估耗时过长。
研究当邀请所有超重/肥胖患者进行风险评估时,通过临时病例发现可识别出多少有心血管药物治疗指征的患者。
对荷兰肥胖流行病学研究的基线测量进行横断面分析,这是一项针对6673名45至65岁人群的基于人群的前瞻性队列研究。我们使用风险预测系统冠状动脉风险评估(SCORE-NL 2011)计算了体重正常、超重和肥胖参与者中有治疗指征的参与者比例。有心血管疾病、糖尿病或类风湿关节炎病史或正在使用心血管药物的参与者不符合临时病例发现的条件,因为他们已被确定为有风险和/或已接受治疗。
在研究人群中,30%已经接受过心血管药物治疗和/或已被确定有相关疾病,因此不符合临时病例发现的条件。在符合条件的参与者中,47%体重正常,41%超重,12%肥胖。超重参与者中有12%有治疗指征,肥胖参与者中有19%有治疗指征。在所有有治疗指征的参与者中,24%尚未接受治疗。在所有有新治疗指征的参与者中,70%超重或肥胖。
在有治疗指征的参与者中,24%尚未接受治疗。邀请超重/肥胖患者进行心血管风险评估可能有助于发现70%这些有治疗指征的剩余患者。