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Compliance with a WHO guideline for cardiovascular disease prevention. A population based cross-sectional study in
Pablo Gulayin1, Laura Gutierrez2, Fernando Lanas3
1Instituto de Efectividad Clínica y Sanitaria. pgulayin@iecs.org.ar.
Insights
Compliance with cardiovascular disease (CVD) prevention guidelines is alarmingly low in Argentina. This highlights an urgent need for improved adherence to pharmacological and non-pharmacological strategies, particularly in lower-income nations.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Cardiovascular disease (CVD) prevention relies on risk classification and adherence to clinical practice guidelines.
- The World Health Organization (WHO) provides comprehensive guidelines for CVD risk management.
- Assessing compliance with these guidelines is crucial for public health interventions.
Purpose of the Study:
- To evaluate compliance with WHO pharmacological and non-pharmacological CVD prevention recommendations.
- To analyze adherence levels within the general population of two Argentinian cities.
Main Methods:
- Analysis of data from the CESCAS population-based study in Argentina.
- Inclusion of 3990 participants to assess medication use and lifestyle factors.
- Comparison of observed practices against WHO 2007 Guidelines for Management of Cardiovascular Risk.
Main Results:
- Low use of antiplatelet (5.6% primary, 20.5% secondary prevention) and lipid-lowering medications (6.7% primary, 15.4% secondary prevention).
- High prevalence of non-adherence: 78.4% low fruit/vegetable intake, 26.9% low physical activity, 28.3% current smoking, 73.9% overweight/obesity, 2.6% excessive alcohol intake.
- Significant gaps identified in both pharmacological and non-pharmacological CVD prevention strategies.
Conclusions:
- A substantially low level of compliance with recommended CVD prevention strategies was observed in the Argentinian population.
- Urgent interventions are required to enhance adherence to clinical practice guidelines for cardiovascular health.
- Focus on improving compliance is especially critical in Low- and Middle-Income Countries.
Introduction:
Current recommendations for cardiovascular disease (CVD) prevention are guided CVD risk classification. This study aims to analyze the level of compliance with pharmacological and non-pharmacological recommendations outlined in the World Health Organization (WHO) CVD prevention clinical practice guideline within the general population of two cities in Argentina.
Methods:
We analyzed the compliance with preventive recommendations from the WHO 2007 Guidelines for Management of Cardiovascular Risk in two cities of Argentina participating in the CESCAS population-based study in the Southern Cone of Latin America.
Results:
3990 participants were included. Considering the WHO recommendations, the use of antiplatelet medication was 5.6% (95% CI 3.5, 8.9) in primary prevention and 20.5% (95%= CI 16.0, 25.9) in secondary prevention. Regarding lipid-lowering medication, it was 6.7% (CI 95%= 4.4, 10.1) and 15.4% (CI 95%= 11.6, 20.1), respectively. As per non-pharmacological recommendations in the general population: low intake of fruit and vegetables was 78.4% (CI 95%= 76.8, 79.9); low physical activity was 26.9% (CI 95%= 25.3, 28.5), current cigarette smoking was 28.3% (CI 95%= 26.6, 30.0), overweight/obesity was 73.9% (CI 95%= 72.3, 75.6), and excessive alcohol intake was 2.6% (CI 95%= 2.1, 3.4).
Conclusions:
It was observed a significantly low compliance with pharmacological and non-pharmacological recommendations for CVD prevention in the general population of two cities in Argentina. Urgent efforts are needed to improve compliance to cardiovascular preventive recommendations promoted by CPG, especially in Low- and Middle- Income Countries.
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