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[Prevalence and management of major risk factors in 500 men with stable coronary disease]
J Ferrières1, D Taraszkiewicz, J B Ruidavets
1Service de Cardiologie, CHU Purpan, Toulouse.
Insights
Management of major cardiovascular risk factors like smoking, high cholesterol, and hypertension is suboptimal in patients with stable coronary artery disease, impacting secondary prevention and life expectancy.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Context:
- Secondary prevention of cardiovascular disease relies on managing major risk factors.
- A gap exists between therapeutic trial publication and clinical practice adoption.
- Stable coronary artery disease patients require ongoing risk factor management.
Purpose:
- To assess the prevalence and management of key cardiovascular risk factors in men with stable coronary artery disease.
- To identify the extent of suboptimal control for hypercholesterolaemia, hypertension, and diabetes.
Summary:
- This study evaluated 500 men (mean age 55.1 years) with stable coronary artery disease.
- High prevalence of hypercholesterolaemia (82%), hypertension (61%), and diabetes (21%) was observed.
- Only 45% of hypercholesterolaemia, 33% of hypertension, and 43% of diabetes cases were adequately controlled.
- 90% of patients had at least two major risk factors (smoking, obesity, hypercholesterolaemia, hypertension, diabetes).
Impact:
- Findings highlight a significant gap in optimal risk factor management for coronary artery disease patients.
- Suboptimal control suggests a need for improved secondary prevention strategies.
- Addressing these modifiable risk factors is crucial for reducing recurrence and improving life expectancy.
Abstract:
Management of major risk factors (smoking, hypercholesterolaemia, hypertension), in the context of secondary prevention, has an impact on recurrence and life expectancy. However, there is a delay between the publication of therapeutic trials and their diffusion within the medical community. The objective of this study was to evaluate the prevalence and management of the main risk factors in a sample of 500 men, with a mean age of 55.1 +/- 7.5 years, presenting with stable coronary artery disease. 11% of subjects had a family history of premature myocardial infarction. Smoking was frequent: 21% of smokers, 60% of ex-smokers. Hypercholesterolaemia (LDL-C > 3.4 mmole/l or treatment) was present in 82% of subjects. Only 45% of treated subjects had an LDL-C < 3.4 mmole/l. Hypertension (systolic blood pressure > or = 140 mmHg or diastolic blood pressure > or = 90 mmHg or treatment) was present in 61% of subjects. Only 33% of treated subjects were controlled. Non-insulin-dependent diabetes mellitus (blood glucose > or = 7.7 mmole/l or treatment) was present in 21% of subjects. Only 43% of treated subjects were controlled. Calculation of the distribution of major risk factors (smoking, pathological obesity, hypercholesterolaemia, hypertension, diabetes) showed that 90% of coronary patients presented at least two risk factors. Overall, the prevalence and management of risk factors in patients with stable coronary artery disease is far from optimal.