[Risk factor control and treatment of atherothrombosis. Spain REACH Registry]

The REACH Registry is the largest worldwide registry designed to obtain information on cardiovascular risk factor control and preventive treatment in a population who have, or are at high risk of having, symptoms of atherothrombosis. The objective of this study is to show the results obtained in a sample of the Spanish population included in that registry.

Registry of consecutive patients who have risk factors only (RFO) for atherothrombosis or who have symptomatic vascular disease (VD): coronary heart disease (CHD) and/or cerebrovascular disease (CVD) and/or peripheral artery disease (PAD). Cardiovascular risk factor control and the use of antithrombotic and lipid lowering therapy were evaluated.

In Spain 2,515 patients were recruited; 297 had RFO and 2,218 had VD: 61.4% with CHD, 36.6% with CVD and 18.7% with PAD. The rates of noncontrolled blood pressure, glycemia, total cholesterol and triglyceride levels in the RFO group compared to those of the VD group were: 76.5% vs 57.1% (p < 0.005), 61.6% vs 30.9% (p < 0.005), 55.7% vs 41.3% (p < 0.005) and 45.5% vs 35.1% (p < 0.005), respectively. The antiplatelet therapy rate in these two groups was 44.1% vs 86.5% (p < 0.005), the anticoagulant therapy rate was 11.4% vs 12.6% (no significant difference) and statin therapy rate was 65.2% vs 65.6% (no significant difference). Significant differences were found among the CHD, CVD and PAD groups as regards noncontrolled blood pressure rate (49.8%. 57.1% and 67.1%, respectively p < 0.005), total cholesterol control rate (41.3%, 48.2% and 50.2% respectively, p < 0.005) as well as antiplatelet therapy rate (86.5%. 83.2% and 81.6% respectively p < 0.005) and statin therapy rate (78.2%. 51.9% and 57.8% respectively p < 0.005).

Cardiovascular risk factor control in subjects at high risk of atherothrombosis or who have established VD is poor. It is poorer in primary prevention and in PAD patients. Whilst the use of statins is insufficient, the use of antithrombotic medication is acceptable in secondary prevention but considerably lacking in primary prevention.