Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2011;64:766-73 - Vol. 64 Num.09 DOI: 10.1016/j.rec.2011.04.016

Risk Factor Treatment and Control in Relation to Coronary Disease Risk in the Spanish Population of the DARIOS Study

José Miguel Baena-Díez a,b, Francisco Javier Félix c, María Grau a, Antonio Cabrera de León d,e, Hector Sanz a, Manuel Leal f, Roberto Elosua a,g, María del Cristo Rodríguez-Pérez d, María Jesús Guembe h, Pere Torán i, Tomás Vega-Alonso j, Honorato Ortiz k, José Fernando Pérez-Castán l, Guillermo Frontera-Juan m, José Lapetra n,o, María José Tormo g,p,q, Antonio Segura r, Daniel Fernández-Bergés s, Jaume Marrugat a,

a Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM, Barcelona, Spain
b Centro de Salud La Marina, IDIAP Jordi Gol, Institut Català de la Salut, Barcelona, Spain
c Centro de Salud Villanueva Norte, Servicio Extremeño de Salud, Villanueva de la Serena, Badajoz, Spain
d Unidad de Investigación de Atención Primaria, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
e Área de Medicina Preventiva y Salud Pública, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, Spain
f Departamento Médico AstraZeneca, Madrid, Spain
g CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
h Servicio de Docencia y Desarrollo Sanitarios y Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Pamplona, Navarra, Spain
i Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Institut Català de la Salut, Barcelona, Spain
j Dirección General de Salud Pública e Investigación, Desarrollo e Innovación, Consejería de Sanidad, Junta de Castilla y León, Valladolid, Spain
k Servicio de Epidemiología, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
l Unidad Docente del Área de Salud Don Benito-Villanueva de la Serena, Hospital Don Benito, Villanueva de la Serena, Badajoz, Spain
m Unidad de Investigación, Hospital Universitario Son Espases, Palma de Mallorca, Baleares, Spain
n Centro de Salud Universitario San Pablo, Servicio Andaluz de Salud, Sevilla, Spain
o CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Madrid, Spain
p Servicio de Epidemiología, Consejería de Sanidad y Consumo, Gobierno de la Región de Murcia, Murcia, Spain
q Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain
r Instituto de Ciencias de la Salud, Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
s Unidad de Investigación Don Benito Villanueva, Programa de Investigación Cardiovascular, Fundesalud, Gerencia de Área Sanitaria Don Benito-Villanueva, Badajoz, Spain

Refers to

Keywords

Risk factors. Hypercholesterolemia. Hypertension. Diabetes mellitus. Drug treatment. Control.

Abstract

Introduction and objectives

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.

Methods

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 90mmhg and glycohemoglobin <7 in hypercholesterolemia we applied both the european societies and health prevention promotion activities programme criteria

Results

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).

Conclusions

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.

1885-5857/© 2011 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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