Article

Although high cardiovascular risk patients should be the main target
of preventive strategies, modifiable risk factors are often inadequately
controlled. AIM: To assess feasibility and results of a comprehensive
personalized method for cardiovascular prevention in high risk patients followed
by their general practitioner. METHODS: Between 2004 and 2007, 12,513 patients
(mean age 64.0 +/- 9.5 years; 61.5% males) with multiple cardiovascular risk
factors or history of atherosclerotic disease were identified and followed for
five years. If control of major modifiable cardiovascular risk factors
(hypertension, hypercholesterolaemia, diabetes, obesity, smoking, unhealthy diet,
physical inactivity) was sub-optimal, at baseline and yearly thereafter general
practitioners planned with patients, with the help of a brief checklist,
preventive interventions to improve the global risk profile. Main outcome was the
control of the seven major modifiable cardiovascular risk factors during
follow-up. Secondary outcome was the incidence of cardiovascular deaths and
hospitalization for cardiovascular reasons according to the improvement in global
cardiovascular risk profile during the first year. RESULTS: Control of all major
modifiable risk factors except physical inactivity improved gradually and
significantly (p < 0.0001) during follow-up.The improvement in the global
cardiovascular risk profile during the first year was independently and
significantly associated with a lower rate of major cardiovascular events in the
following years (hazard ratio 0.939; 95% confidence interval 0.887-0.994, p = 0.03). CONCLUSIONS: Our comprehensive, personalized method for cardiovascular
risk prevention in people at high risk appears feasible in general practice. The
improvement in the global cardiovascular risk profile was associated with a better prognosis.
CI - (c) The European Society of Cardiology 2015.

Langue : ANGLAIS