Global Cardiovascular Risk Assessment in Different Clinical Settings

Background: Cardiovascular diseases still represent the leading cause of morbidity and mortality, worldwide. Early detection and appropriate management of major cardiovascular risk factors in clinical practice may improve preventive strategies in Western countries, including Italy. Objective: To evaluate the prevalence of major cardiovascular risk factors and their impact on routine clinical practice of Italian general practitioners (GPs), cardiologists and diabetologists. Methods: The study involved physicians who participated in an educational project on cardiovascular risk management, the EFFECTUS (Evaluation of Final Feasible Effect of Control Training and Ultra-Sensitisation) programme. Physicians were asked to report data already available in their clinical records of the first ten consecutive adult outpatients during May 2006. Data collection included patients' full medical history and therapies, physical examination (anthropometric parameters and blood pressure levels), laboratory results and diagnostic examinations. Data were then centrally analysed for global cardiovascular risk evaluation and cardiovascular risk profile characterization. The present study provides data from the baseline records of the EFFECTUS programme. Results: A total of 1078 physicians (73% males and 27% females, mean age 50 ± 7 years), of which 841 (78%) were GPs, 140 (13%) cardiologists and 97 (9%) diabetologists, included data from 9904 outpatients (5300 males and 4604 females, mean age 67 ± 9 years). In the overall population, 2504 (25%) subjects were obese, 7436 (75%) had hypertension, 5873 (59%) had dyslipidaemia, 3681 (37%) had diabetes mellitus and 2633 (27%) had a history of ischaemic heart disease, while 1102 (11%) and 1247 (13%) had cerebral or peripheral artery disease, respectively. Significant differences were reported in the prevalence of detected cardiovascular risk factors among physicians operating in different clinical settings. Moreover, different clinical habits were recorded. Conclusions: The present analysis illustrates a very high prevalence of cardiovascular risk factors, irrespective of the clinical settings in which patients were followed, in a vast Italian population. The study also describes differences in management of cardiovascular risk factors among physicians operating in different clinical settings.