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[Goals in risk factor reduction and therapeutic failures]
1Szent János Kórház, III, Belosztály Budapest.
Insights
Vascular event risk factors like high cholesterol, blood sugar, and blood pressure are often not managed effectively in high-risk patients. Most patients fail to reach treatment goals, indicating a gap in current clinical practice.
Area of Science:
- Cardiovascular Medicine
- Metabolic Disorders
- Vascular Health
Context:
- Cardiovascular disease remains a leading cause of mortality worldwide.
- Effective management of modifiable risk factors is crucial for preventing vascular events.
- High-risk patient populations often present complex challenges in achieving therapeutic targets.
Purpose:
- To evaluate the achievement of therapeutic goals for three key modifiable risk factors: hyperlipidemia, hyperglycemia, and hypertension.
- To compare target versus realized risk factor values in 350 high-risk patients.
- To assess the effectiveness of current clinical practices in managing these risk factors.
Summary:
- Analysis of 350 high-risk patients revealed suboptimal control of hyperlipidemia, hyperglycemia, and hypertension.
- A significant number of patients remained untreated for hyperlipidemia (47.3%).
- Despite treatment, many patients exceeded blood sugar and blood pressure goals, with only 5.2% achieving risk factor freedom.
Impact:
- Current clinical practices are insufficient for achieving therapeutic goals in a majority of high-risk patients.
- There is a critical need for improved strategies to manage hyperlipidemia, hyperglycemia, and hypertension.
- The findings highlight a disconnect between treating conditions and achieving optimal patient outcomes, emphasizing the need for better risk factor control.
Unlabelled:
Risk factors' reduction decreases the number of vascular events. The therapy is successful, when target values of risk factors became realised.
Aims:
3 modifiable risk factors - hyperlipidemia, hyperglycemia, hypertension - were checked in 350 high risk patients, comparing the target and the realised values of risk factors.
Methods:
1. Medical history of risk factors' therapy. 2. serum lipids and fasting blood glucose parameters. 3. Physical and ultrasound examinations for cerebro-, cardio- and peripheral vascular diseases, measurement of abdominal circumference and blood pressure. 4. Risk stratification. 5. Statistical analysis.
Results:
1. Mean LDL-cholesterol was 3 +/- 0.94 and 3.3 +/- 0.87 in the group of patients with and without therapy, respectively (p < 0.01). Number of not treated patients is high (47.3%). 2. There were significantly (p = 0.053) more treated patients above blood sugar goals (6,7 mmol/l), than in the group of untreated patients. Mean fasting blood glucose were 8.11 +/- 3,036 and 7.25 +/- 1.925 mmol/l in treated and not treated group of patients, respectively (p = NS). 3. There were significantly (p < 0.00001) more hypertensive patients above therapeutic goal in the treated and less in the untreated group of patients. Mean tension (153,4 +/- 22.42 and 139.7 +/- 20.76) was significantly (p < 0,001) higher in the treated, and lower in the untreated group of patients. 4. Number of risk factors are more in high risk patients. Only 5.2% of patients became free of risk factors by recent clinical practice and in 72.3% remained 2 or 3 factors.
Conclusions:
Most part of patients do not reach the therapeutic goals, and there are many persons without any therapy for hyperlipidaemia. To cure and to treat are different.
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