Awareness of Austrian physicians of risk factors for the development of atherosclerosis

In industrialised countries, coronary heart- (CHD) and other atherosclerosis-associated diseases (AAD) are, with an increasing incidence, responsible for almost half of the deaths among their respective populations. There is unequivocal evidence that medicine should try to achieve a reduction in manifestations of atherosclerosis by efficient preventive strategies. A variety of guidelines have been published during the last decades; nevertheless there is a gap between established recommendations and its application in everyday practice by Austrian physicians. The aim of this survey was to investigate physicians' knowledge of and attitude towards risk factors, preventive strategies and therapy of CHD and other AAD.

The self-administered questionnaire was mailed to 1000 physicians. We obtained an answer from a total of 286 physicians (general practitioners, GP) and specialists in internal medicine, IMS), who were asked about selected items concerning CHD and other AAD and an eventual modification in attitude towards diagnosis and treatment according to their own, personal risk profile.

Risk factors for developing AAD such as elevated CH was identified in 77% (74% GP vs. 84% IMS), hypertension in 77% (76% GP vs. 81% IMS), elevated TG in 37% (40% GP vs. 26% IMS), excess alcohol consumption in 14% of all interrogated physicians (16% GP vs. 9% IMS) respectively. 77% (75% GP vs. 81% IMS) of the physicians considered the CH/HDL-ratio to be important in primary prevention and 83% (81% GP vs. 87% IMS) in secondary prevention; Lipoprotein(a) was considered important in only 9% (8% GP vs. 14% IMS) and 24% (19% GP vs. 41% IMS), respectively.

In summary, all mentioned risk factors were heavily underestimated by Austrian physicians, partly leading to insufficient evaluation and therapeutic interventions. Secondary prevention was managed quite satisfactorily by both GP and IMS according to the Austrian guidelines. The knowledge about primary prevention strategies was significantly worse in GP compared to IMS. There is still a great need for information and training-programs for Austrian physicians to make primary and secondary prevention strategies work more effectively.