BACKGROUND: Family physicians (FPs) play an important role in the prevention of cardiovascular disease (CVD).
AIM: This study aims to assess the determinants of FPs’ knowledge and application of cardiovascular preventive management guidelines at primary health-care setting in Ukraine.
MATERIALS AND METHODS: We performed a cross-sectional study conducted among the 226 FPs in Kharkiv Region, Ukraine. A self-administrated questionnaire was administered, exploring demographic, job characteristics, knowledge of CVD prevention guidelines, and application of CVD guidelines’ questions about the essential items related to diagnosis and management of CVD according to the international/local guidelines.
RESULTS: The results show a very low level of knowledge of guidelines among FPs with 85.8% scoring below the acceptable knowledge level. The guidelines were applied below the acceptable level with 51.3% scoring below the cutoff point. The results indicate that both average scores were below the minimum acceptable level. Lack of knowledge of the CVD preventive care was considered the biggest barrier (62.8%). Lack of counseling skills was the second major barrier (37.9%). Subjectivity of the questions was considered to be the third barrier (32.6%). Lack of counseling skills was the second major barrier (37.9%). Subjectivity of the questions was considered to be the third barrier (32.6%).
CONCLUSIONS: Recognizing the low level of knowledge and application of guidelines among primary care providers and working toward minimizing this problem can be through education, training, and monitoring of the application. This can potentially improve CVD preventive management among patients.
Choosing the best drug for the treatment of cardiac patients remains one of the most important aspects of medical practice. The purpose of this review is to select the optimal beta-blocker for the treatment of patients with chronic heart failure and patients with acute myocardial infarction by comparing the efficacy of carvedilol and metoprolol succinate, as both drugs significantly reduce mortality rates and reduce hospitalization. The results of meta-analyzes, randomized trials comparing the efficacy of carvedilol and metoprolol succinate in the treatment of patients with heart failure with reduced ejection fraction and patients with acute myocardial infarction were analyzed. Conflicting data received. According to the study “Effect of carvedilol vs metoprolol succinate on mortality in heart failure with reduced ejection fraction”, a meta-analysis published in the American Journal of Cardiology in 2013, carvedilol is significantly more effective than metoprolol succinate in treatment of patients with heart failure with reduced ejection fraction and patients with acute myocardial infarction, while meta-analyzes of 2015 and 2017 showed no preference for carvedilol over metoprolol succinate. Based on the results, concluded that the data obtained is not sufficient to argue that carvedilol is more effective than metoprolol succinate for this category of patients in terms of reducing the risk of all-cause mortality, cardiovascular mortality, and reducing hospitalization. This problem requires further extensive research.
Arterial hypertension (AH) remains one of the most pressing health problems, due to its high prevalence. With effective treatment of hypertension, the risk of cardiovascular complications and mortality are significantly reduced, that is, the main goal of the treatment of hypertension is achieved. European and Ukrainian recommendations for the diagnosis and treatment of hypertension distinguish five main classes of antihypertensive drugs: diuretics, β-blockers, calcium antagonists, angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Based on the foregoing, we can conclude that the third-generation calcium antagonist lercanidipine is a highly effective, longacting antihypertensive drug for the treatment of hypertension of any stage and severity. It has organoprotective properties, is metabolically neutral, is well tolerated and can be successfully used both as monotherapy and in combination with any other (except dihydropyridine calcium antagonists) antihypertensive drugs in both men and women.
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