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Which patient and treatment factors are related to successful cardiovascular risk score reduction in general

Ans H Tiessen1, Andries J Smit, Jan Broer

  • 1University of Groningen, University Medical Center Groningen, Department General Practice, Groningen, The Netherlands. a.h.tiessen@umcg.nl

BMC Family Practice
|August 24, 2013
PubMed

Insights

High baseline cardiovascular risk (SCORE) and medication changes, particularly lipid-lowering drugs, significantly reduced 10-year mortality risk in general practice patients. Medication adjustments were key to risk reduction.

Area of Science:

  • Cardiology
  • General Practice
  • Preventive Medicine

Background:

  • Cardiovascular disease (CVD) is a major global health concern.
  • Identifying factors for successful CVD risk reduction in primary care is crucial.
  • This study examined patient and treatment factors influencing cardiovascular risk estimation.

Purpose of the Study:

  • To identify patient and treatment factors associated with changes in cardiovascular risk.
  • To analyze the impact on the Systematic Coronary Risk Evaluation (SCORE) 10-year risk.

Main Methods:

  • A one-year intervention program for 179 general practice patients with mild-moderate cardiovascular risk.
  • Included structured lifestyle and medication management by practice nurses, with optional self-monitoring.
  • Data from the SPRING-RCT (Self-monitoring and Prevention of RIsk factors by Nurse practitioners) were analyzed using univariate and multivariate methods.

Main Results:

  • Baseline SCORE and changes in lipid-lowering or antihypertensive medications were significantly related to SCORE changes.
  • Medication adjustments were observed in 12% of participants and strongly correlated with risk reduction.
  • The impact of home monitoring devices may have been masked by medication effects.

Conclusions:

  • Treatment should be targeted towards individuals presenting with a high SCORE.
  • Medication adjustments, even in a small proportion of patients, significantly impact cardiovascular risk reduction.
  • Further research may be needed to elucidate the independent effect of self-monitoring devices.
Abstract

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