1
|
Hagen AN, Ariansen I, Hanssen TA, Lappegård KT, Eggen AE, Løchen ML, Njølstad I, Wilsgaard T, Hopstock LA. Achievements of primary prevention targets in individuals with high risk of cardiovascular disease: an 8-year follow-up of the Tromsø study. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeac061. [PMID: 36284643 PMCID: PMC9583183 DOI: 10.1093/ehjopen/oeac061] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/05/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Aims To study change over 8 years in cardiovascular risk, achievement of national guideline-based treatment targets of lipids, blood pressure (BP) and smoking in primary prevention of cardiovascular disease (CVD), medication use, and characteristics associated with target achievement among individuals with high CVD risk in a general population. Methods and results We followed 2524 women and men aged 40-79 years with high risk of CVD attending the population-based Tromsø study in 2007-08 (Tromsø6) to their participation in the next survey in 2015-16 (Tromsø7). We used descriptive statistics and regression models to study change in CVD risk and medication use, and characteristics associated with treatment target achievement. In total, 71.4% reported use of BP- and/or lipid-lowering medication at second screening. Overall, CVD risk decreased during follow-up, with a larger decrease among medication users compared with non-users. Treatment target achievement was 31.0% for total cholesterol <5 mmol/L, 27.3% for LDL cholesterol <3 mmol/L, 43.4% for BP <140/90 (<135/85 if diabetes) mmHg, and 85.4% for non-smoking. A total of 9.8% reached all treatment targets combined. Baseline risk factor levels and current medication use had the strongest associations with treatment target achievement. Conclusion We found an overall improvement in CVD risk factors among high-risk individuals over 8 years. However, guideline-based treatment target achievement was relatively low for all risk factors except smoking. Medication use was the strongest characteristic associated with achieving treatment targets. This study has demonstrated that primary prevention of CVD continues to remain a major challenge.
Collapse
Affiliation(s)
- Amalie Nilsen Hagen
- Department of Medicine, Nordland Hospital, Parkveien 96, Nordland, 8005 Bodø, Norway
| | - Inger Ariansen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Folkehelseinstituttet, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Tove Aminda Hanssen
- Department of Cardiology, University Hospital of North Norway, Universitetssykehuset Nord-Norge HF Postboks 100, 9038 Tromsø, Norway
- Department of Health and Care Sciences, UiT The Arctic University of Norway, UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø, Norway
| | - Knut Tore Lappegård
- Department of Medicine, Nordland Hospital, Parkveien 96, Nordland, 8005 Bodø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Cardiology, University Hospital of North Norway, Universitetssykehuset Nord-Norge HF Postboks 100, 9038 Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, UiT The Arctic University of Norway, UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø, Norway
| | - Laila Arnesdatter Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, UiT Noregs arktiske universitet Postboks 6050 Langnes, 9037 Tromsø, Norway
| |
Collapse
|
2
|
Sarzani R, Laureti G, Gezzi A, Spannella F, Giulietti F. Single-pill fixed-dose drug combinations to reduce blood pressure: the right pill for the right patient. Ther Adv Chronic Dis 2022; 13:20406223221102754. [PMID: 35769133 PMCID: PMC9235298 DOI: 10.1177/20406223221102754] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/28/2022] [Indexed: 11/17/2022] Open
Abstract
Arterial hypertension is one of the major causes of cardiovascular morbidity and mortality worldwide. Effective and sustained reduction in blood pressure is essential to reduce individual cardiovascular risk. In daily clinical practice, single-pill fixed-dose combinations of different drug classes are important therapeutic resources that could improve both treatment adherence and cardiovascular risk management by targeting distinct pathophysiological mechanisms. The aim of this practical narrative review is to help physicians choosing the right single-pill fixed-dose combination for the right patient in the daily clinical practice, based on the individual clinical phenotype and cardiovascular risk profile.
Collapse
Affiliation(s)
- Riccardo Sarzani
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS, INRCA, via della Montagnola 81, 60127 Ancona, Italy
| | - Giorgia Laureti
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS, INRCA, Ancona, Italy
| | - Alessandro Gezzi
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS, INRCA, Ancona, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS, INRCA, Ancona, Italy
| | - Federico Giulietti
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS, INRCA, Ancona, Italy
| |
Collapse
|
3
|
Urbonas G, Vencevičienė L, Valius L, Krivickienė I, Petrauskas L, Lazarenkienė G, Karpavičienė J, Briedė G, Žučenkienė E, Vencevičius K. Primary Prevention of Cardiovascular Risk in Lithuania-Results from EUROASPIRE V Survey. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E134. [PMID: 32197516 PMCID: PMC7143447 DOI: 10.3390/medicina56030134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 03/09/2020] [Accepted: 03/13/2020] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Cardiovascular disease (CVD) prevention guidelines define targets for lifestyle and risk factors for patients at high risk of developing CVD. We assessed the control of these factors, as well as CVD risk perception in patients enrolled into the primary care arm of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE V) survey in Lithuania. Materials and Methods: Data were collected as the part of the EUROASPIRE V survey, a multicenter, prospective, cross-sectional observational study. Adults without a documented CVD who had been prescribed antihypertensive medicines and/or lipid-lowering medicines and/or treatment for diabetes (diet and/oral antidiabetic medicines and/or insulin) were eligible for the survey. Data were collected through the review of medical records, patients' interview, physical examination and laboratory tests. Results: A total of 201 patients were enrolled. Very few patients reached targets for low-density lipoprotein cholesterol (LDL-C) (4.5%), waist circumference (17.4%) and body mass index (15.4%). Only 31% of very high CVD risk patients and 52% of high-risk patients used statins. Blood pressure target was achieved by 115 (57.2%) patients. Only 21.7% of patients at very high actual CVD risk and 27% patients at high risk correctly estimated their risk. Of patients at moderate actual CVD risk, 37.5% patients accurately self-assessed the risk. About 60%-80% of patients reported efforts to reduce the intake of sugar, salt or alcohol; more than 70% of patients were current nonsmokers. Only a third of patients reported weight reduction efforts (33.3%) or regular physical activity (27.4%). Conclusions: The control of cardiovascular risk factors in a selected group of primary prevention patients was unsatisfactory, especially in terms of LDL-C level and body weight parameters. Many patients did not accurately perceive their own risk of developing CVD.
Collapse
Affiliation(s)
- Gediminas Urbonas
- Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania; (L.V.); (I.K.); (L.P.); (G.L.); (J.K.)
| | - Lina Vencevičienė
- Institute of Clinical Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (L.V.); (G.B.); (E.Ž.); (K.V.)
| | - Leonas Valius
- Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania; (L.V.); (I.K.); (L.P.); (G.L.); (J.K.)
| | - Ieva Krivickienė
- Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania; (L.V.); (I.K.); (L.P.); (G.L.); (J.K.)
| | - Linas Petrauskas
- Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania; (L.V.); (I.K.); (L.P.); (G.L.); (J.K.)
| | - Gintarė Lazarenkienė
- Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania; (L.V.); (I.K.); (L.P.); (G.L.); (J.K.)
| | - Justina Karpavičienė
- Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania; (L.V.); (I.K.); (L.P.); (G.L.); (J.K.)
| | - Gabrielė Briedė
- Institute of Clinical Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (L.V.); (G.B.); (E.Ž.); (K.V.)
| | - Emilė Žučenkienė
- Institute of Clinical Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (L.V.); (G.B.); (E.Ž.); (K.V.)
| | - Karolis Vencevičius
- Institute of Clinical Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (L.V.); (G.B.); (E.Ž.); (K.V.)
| |
Collapse
|
4
|
Cai P, Zhong W, Wang Y, Wang X. Effects of white-coat, masked and sustained hypertension on coronary artery stenosis and cardiac arrhythmia. Hypertens Res 2020; 43:121-131. [PMID: 31624353 PMCID: PMC8076024 DOI: 10.1038/s41440-019-0342-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/18/2019] [Indexed: 11/29/2022]
Abstract
This study aimed to investigate whether hypertension phenotypes such as white-coat hypertension (WCHT), diagnosed with the addition of nighttime blood pressure (BP) criteria, are related to coronary artery stenosis (CAS) and cardiac arrhythmia. In this cross-sectional observational study, 844 participants who did not use antihypertensive, lipid-lowering, and antiplatelet drugs were selected. The subjects were divided into normotensive (NT), WCHT, masked hypertension (MHT), and sustained hypertension (SHT) groups based on the results of clinic BP measurement and ambulatory BP monitoring. Coronary angiography and ambulatory electrocardiography were performed to determine the participants' CAS and cardiac arrhythmia status. Coronary angiography revealed 556 patients with CAS and 288 participants with normal coronary arteries. The chi-squared test showed that the incidence of CAS was higher in the MHT and SHT groups than in the NT group, while no significant change was found in the WCHT group (P = 0.003, P < 0.001, P = 0.119). The logarithm of the Gensini score was used to compare the degree of CAS between the groups. Multiple linear regression analysis showed that the degree of CAS was higher in the WCHT, MHT, and SHT groups than in the NT group (P < 0.05). The incidences of frequent atrial premature beats, atrial tachycardia, and ventricular cardiac arrhythmia were significantly higher in the WCHT and SHT groups than in the NT group, while only ventricular cardiac arrhythmia changes were observed in the MHT group. This study found that hypertension phenotypes such as WCHT were closely associated with CAS and cardiac arrhythmia.
Collapse
Affiliation(s)
- Peng Cai
- Department of Cardiology, Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Weitian Zhong
- Department of Cardiology, Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Yan Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, China.
| | - Xukai Wang
- Department of Cardiology, Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing, China.
| |
Collapse
|
5
|
Fan W, Song Y, Inzucchi SE, Sperling L, Cannon CP, Arnold SV, Kosiborod M, Wong ND. Composite cardiovascular risk factor target achievement and its predictors in US adults with diabetes: The Diabetes Collaborative Registry. Diabetes Obes Metab 2019; 21:1121-1127. [PMID: 30609214 DOI: 10.1111/dom.13625] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/27/2018] [Accepted: 01/02/2019] [Indexed: 12/20/2022]
Abstract
AIM To investigate multiple risk factor target attainment in adults with diabetes mellitus (DM) for atherosclerotic cardiovascular disease (ASCVD) prevention and the predictors of such attainment in a contemporary DM registry. METHODS In the US Diabetes Collaborative Registry we identified patients who were at target for glycated haemoglobin (HbA1c; < 53 mmol/mol (7%) or < 64 mmol/mol (8%) if with ASCVD), LDL cholesterol (< 2.6 mmol/L (100 mg/dL) or < 1.8 mmol/L (70 mg/dL) 1.8 if with ASCVD) and blood pressure (BP; <140/90 mmHg and < 130/80 mmHg as an alternate), and who had non-smoking status, by sex, race and history of ASCVD. Multiple logistic regression was used to examine predictors of target attainment. RESULTS In 74 393 patients with DM who had available data (mean age 69.0 years, 41.0% women), overall target attainment for HbA1c, BP, LDL cholesterol and non-smoking status was 73.6%, 69.0% (40.3% for BP <130/80 mmHg), 48.6% and 85.2%, respectively. Only 21.6% (13.0% with BP <130/80 mmHg) were at target for all four measures, and the proportions were higher in men (23.6%) versus women (18.6%) and in white people (22.5%) versus African-American people (14.7%) and people of other races (20.8%; P < 0.01). A total of 62.4% were on a moderate-/high-intensity statin. Age (≥65 years: odds ratio [OR] 1.9, 95% confidence interval [CI] 1.7-2.0; and 55-64 years: OR 1.3, 95% CI 1.2-1.4 vs. <55 years), male sex (OR 1.3, 95% CI 1.3-1.4), white race (OR 1.4, 95% CI 1.3-1.5), middle or high income (ORs 1.1, 95% CI 1.1-1.2 or 1.4, 95% CI 1.4-1.5, respectively) were associated, and depression (OR 0.9, 95% CI 0.8-1.0) was inversely associated with meeting all four targets (all P = 0.01 to P < 0.001). CONCLUSIONS In our US registry of patients with DM, only one in five patients were achieving comprehensive risk factor control. Multifactorial interventions will be necessary to optimize ASCVD risk factor control.
Collapse
Affiliation(s)
- Wenjun Fan
- University of California, Irvine School of Medicine, Irvine, California
| | - Yang Song
- Baim Institute, Boston, Massachusetts
| | | | | | - Christopher P Cannon
- Baim Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | | | | | - Nathan D Wong
- University of California, Irvine School of Medicine, Irvine, California
| |
Collapse
|
6
|
Presta V, Figliuzzi I, Miceli F, Coluccia R, Fogacci F, Cicero AFG, Ferrucci A, Borghi C, Volpe M, Tocci G. Achievement of low density lipoprotein (LDL) cholesterol targets in primary and secondary prevention: Analysis of a large real practice database in Italy. Atherosclerosis 2019; 285:40-48. [PMID: 31003091 DOI: 10.1016/j.atherosclerosis.2019.03.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 02/19/2019] [Accepted: 03/21/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Target and intensity of low-density lipoprotein cholesterol (LDL-C) lowering therapy should be tailored according to the individual global cardiovascular (CV) risk. We aimed at retrospectively evaluating real-life LDL-C goal attainment and predictive factors for predefined LDL-C therapeutic goals both in primary and secondary prevention. METHODS We collected data from a large cohort of outpatients aged 40-65 years, followed by general practitioners, cardiologists and diabetologists in Italy. All data were centrally analysed for global CV risk assessment and rates of control of major CV risk factors, including LDL-C. Study population was stratified according to the presence or absence of previous CV events, including coronary artery disease (CAD), peripheral artery disease (PAD) or stroke/TIA. CV risk profile characterization was based on the European SCORE. Predefined therapeutic goals were set according to the European guidelines on dyslipidaemia: LDL-C levels <70 mg/dl for very high CV risk patients in primary prevention and for those in secondary prevention; <100 mg/dl LDL-C levels for high CV risk patients in primary prevention. Logistic regression analysis with clinical covariates was used to identify predictive factors for achieving these goals; lipid lowering therapy entered in the analysis as continuous (model 1) or categorical variable (model 2). RESULTS We included 4,142 outpatients (43,7% female, age 58.0 ± 5.2 years, BMI 28.5 ± 5.0 kg/m2) among whom 2,964 (71.6%) in primary and 1,178 (28.4%) in secondary prevention. In primary prevention, none of the patients at very high CV risk had LDL-C <70 mg/dl and 8.9% of patients at high CV risk showed LDL-C <100 mg/dl. Only 5.8% of patients in secondary prevention had LDL-C levels <70 mg/dl, specifically 6.5% of patients with CAD, 2.6% of patients with PAD and 4.7% of patients with CVD (p < 0.001). Beyond diabetes and lipid lowering therapy, high risk SCORE estimation resulted a strong and independent predictor for the lack of achieving all predefined therapeutic targets, including LDL-C <100 mg/dl [OR: 0.806 (0.751-0.865)); p < 0.001], and LDL-C <70 mg/dl [OR: 0.712 (0-576-0.880); p = 0.002], in primary prevention. CONCLUSIONS Despite high or very high SCORE risk and use of lipid lowering therapies, we observed poor achievement of LDL-C targets in this large cohort of outpatients followed in a setting of real practice in Italy.
Collapse
Affiliation(s)
- Vivianne Presta
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Ilaria Figliuzzi
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Francesca Miceli
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | | | - Federica Fogacci
- Medical and Surgical Sciences Department, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | | | - Andrea Ferrucci
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Claudio Borghi
- Medical and Surgical Sciences Department, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Massimo Volpe
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - Giuliano Tocci
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy.
| |
Collapse
|
7
|
Therapeutic Approach to Hypertension Urgencies and Emergencies During Acute Coronary Syndrome. High Blood Press Cardiovasc Prev 2018; 25:253-259. [DOI: 10.1007/s40292-018-0275-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 07/24/2018] [Indexed: 10/28/2022] Open
|
8
|
Figliuzzi I, Presta V, Citoni B, Miceli F, Simonelli F, Battistoni A, Coluccia R, Ferrucci A, Volpe M, Tocci G. Achievement of multiple therapeutic targets for cardiovascular disease prevention: Retrospective analysis of real practice in Italy. Clin Cardiol 2018; 41:788-796. [PMID: 29604091 DOI: 10.1002/clc.22955] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 03/10/2018] [Accepted: 03/27/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Pharmacological therapy in patients at high cardiovascular (CV) risk should be tailored to achieve recommended therapeutic targets. HYPOTHESIS To evaluate individual global CV risk profile and to estimate the control rates of multiple therapeutic targets for in adult outpatients followed in real practice in Italy. METHODS Data extracted from a cross-sectional, national medical database of adult outpatients in real practice in Italy were analyzed for global CV risk assessment and rates of control of major CV risk factors, including hypertension, dyslipidemia, diabetes, and obesity. CV risk characterization was based on the European SCORE equation and the study population stratified into 3 groups: low risk (<2%), intermediate risk (≥2%-<5%), and high to very high risk (≥5%). RESULTS We analyzed data from 7158 adult outpatients (mean age, 57.7 ±5.3 years; BMI, 28.3 ±5.0 kg/m2 , BP, 136.0 ±14.3/82.2 ±8.3 mm Hg; total cholesterol, 212.7 ±40.7 mg/dL), among whom 2029 (45.2%) had low, 1730 (24.2%) intermediate, and 731 (16.3%) high to very high risk. Increased SCORE risk was an independent predictor of poor achievement of diastolic BP <90 mm Hg (OR: 0.852, 95% CI: 0.822-0.882), LDL-C < 130 mg/dL (OR: 0.892, 95% CI: 0.861-0.924), HDL-C > 40 (males)/>50 (females) mg/dL (OR: 0.926, 95% CI: 0.895-0.958), triglycerides <160 mg/dL (OR: 0.925, 95% CI: 0.895-0.957), and BMI <25 kg/m2 (OR: 0.888, 95% CI: 0.851-0.926), even after correction for diabetes, renal function, pharmacological therapy, and referring physicians (P < 0.001). CONCLUSIONS Despite low prevalence and optimal medical therapy, individuals with high to very high SCORE risk did not achieve recommended therapeutic targets in a real-world practice.
Collapse
Affiliation(s)
- Ilaria Figliuzzi
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Vivianne Presta
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Barbara Citoni
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Francesca Miceli
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Francesca Simonelli
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Allegra Battistoni
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | | | - Andrea Ferrucci
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Massimo Volpe
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Giuliano Tocci
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| |
Collapse
|