A comprehensive guidelines-based approach reduces cardiovascular risk in everyday practice: the VARO study

作者：Stulc Tomas^*; Lanska Vera; Snejdrlova Michaela; Vrablik Michal; Prusikova Martina; Ceska Richard

来源：Archives of Medical Science, 2017, 13(4): 705-710.

DOI：10.5114/aoms.2016.64865

• global cardiovascular risk
• hypertension
• dyslipidemia
• cardiovascular risk reduction
• guidelines implementation

Introduction: The aim of study was to investigate the possibility of cardiovascular risk improvement through systematic identification of high-risk individuals and treatment in accordance with current guidelines using modern therapy in daily clinical practice.
Material and methods: Two hundred and sixty-three physicians participated in the study. The physicians were asked to screen for cardiovascular risk factors in patients presenting with unrelated problems and to re-evaluate the attainment of treatment goals in those with already known risk factors. Each physician enrolled up to 20 consecutive patients with hypertension and/or hyperlipidemia. A total of 3015 patients were included. Cardiovascular risk was assessed using the SCORE system. Risk factors were treated in accordance with current national guidelines. The therapy of hyperlipidemia and hypertension was preferentially based on rosuvastatin, amlodipine and valsartan. Further medication was at the discretion of the attending physician. Patients were examined at baseline and after 3 and 6 months.
Results: The principal result is that global cardiovascular risk decreased by 35% (from 8.9 +/- 6.4 to 5.9 +/- 4.4, p < 0.001). Systolic and diastolic blood pressure decreased by 12.5% (from 152 +/- 18 to 133 +/- 11, p < 0.001) and 11.4% (from 88 +/- 11 to 78 +/- 7, p < 0.001). The level of total cholesterol decreased 21% (from 6.3 +/- 1.2 to 5.0 +/- 0.9, p < 0.001) and the concentration of LDL-C decreased 28% (from 3.9 +/- 1.1 to 2.8 +/- 0.8, p < 0.001). HDL-C increased by 7% (from 1.43 +/- 0.58 to 1.53 +/- 0.56, p < 0.001) and triglycerides decreased by 25% (from 2.4 +/- 1.3 to 1.8 +/- 0.9, p < 0.001). Blood pressure and LDL-C target values were reached in 68% and 34% of patients, respectively.
Conclusions: The VARO study demonstrates that in daily practice settings, both individual risk factors and global cardiovascular risk are significantly improved through the systematic identification of high-risk individuals and their treatment in accordance with current guidelines using modern pharmacotherapy.

• 出版日期2017