Global cardiovascular risk evaluation in Italy: a cross-sectional survey in general practice

The aim of our work was to evaluate, in a general practice setting, the attitude of general practitioners in determining the individual coronary risk.

The coronary risk was determined among patients aged 30 to 74 years using the following parameters: gender, age, smoking habits, diagnosis of diabetes mellitus, systolic blood pressure, and total cholesterol. We evaluated the records of 446,331 subjects collected by 481 general practitioners working throughout Italy.

Except for age, gender and diabetes mellitus, risk factors were largely under-recorded: blood pressure in 37.0% of the total patients, total cholesterol in 34.3%, smoking habits in 21.9%. Recording was substantially low even in patients who were prescribed with antihypertensive drugs and/or lipid-lowering drugs: blood pressure in 80.6% of the patients, total cholesterol in 69.1%, smoking habits in 46.1%. Cardiovascular risk factors were more frequently recorded as age increased and slightly more among women as compared to men. Obviously, it is possible that risk factors had been assessed but not recorded.

Cardiovascular risk factors are substantially under-recorded among Italian general practitioners thus impairing adequate preventive treatment. A systematic, well programmed approach may theoretically lead to evaluate the majority of the target population within a few years.