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A comprehensive guidelines-based approach reduces cardiovascular risk in everyday practice: the VARO study
Tomáš Štulc1, Věra Lánská2, Michaela Šnejdrlová1
13 Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Prague, Czech Republic.
Insights
Systematic identification and treatment of high-risk individuals significantly reduced global cardiovascular risk by 35% in daily practice. Modern pharmacotherapy, including rosuvastatin, amlodipine, and valsartan, improved blood pressure and lipid levels effectively.
Area of Science:
- Cardiology
- Preventive Medicine
- Pharmacotherapy
Background:
- Cardiovascular disease remains a leading cause of mortality worldwide.
- Effective risk management strategies are crucial for public health.
- Current guidelines recommend systematic identification and treatment of high-risk individuals.
Purpose of the Study:
- To evaluate the impact of systematic cardiovascular risk assessment and modern pharmacotherapy on risk reduction in daily clinical practice.
- To investigate the effectiveness of current treatment guidelines in managing hypertension and hyperlipidemia.
- To assess changes in cardiovascular risk factors over a 6-month period.
Main Methods:
- A study involving 263 physicians and 3015 patients with hypertension and/or hyperlipidemia.
- Cardiovascular risk was assessed using the SCORE system.
- Patients received treatment according to national guidelines, primarily with rosuvastatin, amlodipine, and valsartan, with follow-up at 3 and 6 months.
Main Results:
- Global cardiovascular risk decreased by 35% (p < 0.001).
- Significant reductions were observed in systolic blood pressure (12.5%), diastolic blood pressure (11.4%), total cholesterol (21%), LDL-C (28%), and triglycerides (25%).
- HDL-C increased by 7% (p < 0.001), and treatment goals were met for blood pressure (68%) and LDL-C (34%).
Conclusions:
- The VARO study confirms that systematic identification and treatment of high-risk individuals significantly improve cardiovascular risk factors in real-world clinical settings.
- Modern pharmacotherapy, guided by current standards, is effective in managing hypertension and hyperlipidemia.
- The findings support the implementation of proactive cardiovascular risk management protocols in routine healthcare.
Introduction:
The aim of study was to investigate the possibility of cardiovascular risk improvement through systematic identification of high-risk individuals and treatment in accordance with current guidelines using modern therapy in daily clinical practice.
Material And Methods:
Two hundred and sixty-three physicians participated in the study. The physicians were asked to screen for cardiovascular risk factors in patients presenting with unrelated problems and to re-evaluate the attainment of treatment goals in those with already known risk factors. Each physician enrolled up to 20 consecutive patients with hypertension and/or hyperlipidemia. A total of 3015 patients were included. Cardiovascular risk was assessed using the SCORE system. Risk factors were treated in accordance with current national guidelines. The therapy of hyperlipidemia and hypertension was preferentially based on rosuvastatin, amlodipine and valsartan. Further medication was at the discretion of the attending physician. Patients were examined at baseline and after 3 and 6 months.
Results:
The principal result is that global cardiovascular risk decreased by 35% (from 8.9 ±6.4 to 5.9 ±4.4, p < 0.001). Systolic and diastolic blood pressure decreased by 12.5% (from 152 ±18 to 133 ±11, p < 0.001) and 11.4% (from 88 ±11 to 78 ±7, p < 0.001). The level of total cholesterol decreased 21% (from 6.3 ±1.2 to 5.0 ±0.9, p < 0.001) and the concentration of LDL-C decreased 28% (from 3.9 ±1.1 to 2.8 ±0.8, p < 0.001). HDL-C increased by 7% (from 1.43 ±0.58 to 1.53 ±0.56, p < 0.001) and triglycerides decreased by 25% (from 2.4 ±1.3 to 1.8 ±0.9, p < 0.001). Blood pressure and LDL-C target values were reached in 68% and 34%of patients, respectively.
Conclusions:
The VARO study demonstrates that in daily practice settings, both individual risk factors and global cardiovascular risk are significantly improved through the systematic identification of high-risk individuals and their treatment in accordance with current guidelines using modern pharmacotherapy.
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Initial Enquiry
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Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
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