Clinical cardiology 2018 03 31() doi 10.1002/clc.22955
Pharmacological therapy in patients at high cardiovascular (CV) risk should be tailored in order to achieve recommended therapeutic targets.
To evaluate the achievement of multiple therapeutic targets in a large cohort of adult outpatients followed in real practice in Italy.
Data extracted from a cross-sectional, national medical database were analysed for global CV risk assessment and rates of control of major CV risk factors, including hypertension, dyslipidaemia, diabetes, and obesity. CV risk characterization was based on European SCORE equation, and study population stratified into three groups: low (<2%), intermediate (≥2% - <5%) and high-to-very-high (≥5%) risk. RESULTS
We analysed data from 7,158 adult outpatients (age 57.7±5.3 years, BMI 28.3±5.0 kg/m2, BP 136.0±14.3/82.2±8.3 mmHg, total cholesterol 212.7±40.7 mg/dl), among whom 2,029 (45.2%) had low, 1,730 (24.2%) intermediate and 731 (16.3%) high-to-very-high risk. Increased SCORE risk resulted an independent predictor of poor achievement of diastolic BP <90 mmHg (OR: 0.852; 95% CI: 0.822-0.882), LDL cholesterol <130 mg/dl (OR: 0.892; 95% CI: 0.861-0.924), HDL cholesterol >40(M)/>50(F) 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
The present analysis confirmed that despite low prevalence and optimal medical therapy, high-to-very-high SCORE risk individuals did not achieved the recommended therapeutic targets in a setting of real practice.