Hosseinzadeh-Shanjani Zarrintaj, Hoveidamanesh Soodabeh, Ramezani Mozhdeh, Davoudi Farnoush, Nojomi Marzieh
Assistant Professor, Department of Community Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Community Medicine Specialist, Preventive Medicine and Public Health Research Center AND Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.
ARYA Atheroscler. 2019 Jan;15(1):38-43. doi: 10.22122/arya.v15i1.1774.
Cardiovascular disease (CVD) is the leading cause of death globally and has enormous costs for healthcare systems. This disease has a strong association with lifestyle behaviors. Therefore, applying reliable and effective strategies for prevention and treatment of CVD is important. In this study, we aimed to evaluate the adherence of cardiologist physicians to the American Heart Association (AHA) guideline for prevention of CVD.
Using a cross-sectional study, data were gathered for 208 patients using their medical records in the cardiology ward of a general teaching hospital. A physician systematically reviewed the medical records and completed the checklist in each domain. Adherence to the AHA guideline was evaluated in treating physician's choices and recommendations regarding these eight variables: hypertension (HTN), dietary intake, weight management, diabetes management, physical activity, blood lipid management, smoking, and aspirin prescription.
Medical records of 208 patients (109 men and 99 women) with the mean age of 62 ± 14 years were reviewed. The frequency of CVDs was 5.3% for coronary heart failure (HF) and 67.8% for the acute coronary syndrome (ACS). Cardiovascular risk factors of patients were HTN (53.8%), diabetes (34.6%), hyperlipidemia (17.3%), smoking (17.8%), and obesity (31.7%). We found a proportion of 59%, 15%, and 26% for high, moderate, and low adherence to AHA guideline, respectively.
Our study showed almost 60% high adherence to the AHA guideline by physicians in a teaching hospital. The most and the least adherence to the AHA guideline were for obesity and diabetes recommendations, respectively. More studies are needed to evaluate preventive guideline adherence in Iran. Establishing national preventive and therapeutic guidelines may increase the physicians' adherence to them.
心血管疾病（CVD）是全球首要死因，给医疗系统带来巨大成本。该疾病与生活方式行为密切相关。因此，应用可靠且有效的心血管疾病预防和治疗策略至关重要。在本研究中，我们旨在评估心脏病专家对美国心脏协会（AHA）心血管疾病预防指南的遵循情况。
采用横断面研究，通过一所普通教学医院心内科病房208例患者的病历收集数据。一名医生系统回顾病历并完成各领域的检查表。从治疗医生对以下八个变量的选择和建议方面评估对AHA指南的遵循情况：高血压（HTN）、饮食摄入、体重管理、糖尿病管理、身体活动、血脂管理、吸烟和阿司匹林处方。
回顾了208例患者（109名男性和99名女性）的病历，平均年龄为62±14岁。冠心病心力衰竭（HF）的心血管疾病发生率为5.3%，急性冠状动脉综合征（ACS）为67.8%。患者的心血管危险因素包括高血压（53.8%）、糖尿病（34.6%）、高脂血症（17.3%）、吸烟（17.8%）和肥胖（31.7%）。我们发现对AHA指南的高、中、低遵循比例分别为59%、15%和26%。
我们的研究表明，教学医院中医生对AHA指南的高遵循率近60%。对AHA指南遵循率最高和最低的分别是肥胖和糖尿病方面的建议。需要更多研究来评估伊朗对预防指南的遵循情况。制定国家预防和治疗指南可能会提高医生对其的遵循率。
