[Use of drugs in the REACH registry: from guidelines to clinical practice]

The REACH registry allows the degree of control of risk factors associated with atherothrombosis to be evaluated. Although 90% were taking at least one antihypertensive agent, hypertension was controlled in only 42.9% of the patients with vascular disease. This inadequate control may have multiple causes but the main factors are probably clinical inertia, lack of treatment adherence and the absence of combination therapies. Among patients with vascular disease, the percentage of those with good diabetes mellitus control was acceptable. The proportion of subjects with healthy cholesterol levels was suboptimal, even though 71.3% were receiving statins. The percentage of active smokers was 12% in the group of patients with vascular disease. More than 80% of the total population was taking at least one antiplatelet agent. Although the use of these agents is widespread in secondary prevention and that of lipid-lowering drugs is increasing, blood pressure and cholesterol goals are not being achieved in most patients with established vascular disease. In the REACH study, a substantial percentage of patients are not achieving adequate control of cardiovascular risk factors and are not receiving the treatments recommended in clinical practice guidelines.