Implementation of therapeutic recommendations in high cardiovascular-risk patients. The Polish population of EUROASPIRE V survey

et al. 2023

JCM

Self Cite

To assess the determinants of lipid parameters in primary care patients without diagnosed cardiovascular disease (CVD), a cross-sectional study was conducted during 2018–2019 with a total of 200 patients. The following lipid parameters were measured: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), small, dense LDL (sdLDL-C), and lipoprotein (a) (Lp(a)). Predictors of elevated and adequately controlled lipid parameters were assessed with logistic regression analysis. Older age was related to higher risk of TC ≥ 6.2 mmol/L [OR 1.03 (95% CI 1.0–1.05)], sdLDL-C ≥ 1.0 mmol/L [OR 1.05 (95% CI 1.0–1.1)], and decreased risk of Lp(a) ≥ 50 mg/dL [OR 0.97 (95% CI 0.94–0.99)]. Patients with diabetes mellitus (DM) had increased probability of TG ≥ 2.25 mmol/L [OR 3.77 (95% CI 1.34–10.6)] and Lp(a) ≥ 50 mg/dL [OR 2.97 (1.34–6.10)] as well as adequate control of TG and Lp(a). Higher material status was related to lower risk of TC ≥ 6.2 mmol/L [OR 0.19 (95% CI 0.04–0.82)] and LDL-C ≥ 3.6 mmol/L [OR 0.33 (95% CI 0.12–0.92)]. High BMI was related to increased [OR 1.14 (95% CI 1.02–1.29)], and female gender [OR 0.33 (95% CI 0.12–0.96)] and hypertension [OR 0.29 (95% CI 0.1–0.87)] to decreased risk of TG ≥ 2.25 mmol/L [OR 1.14 (95% CI 1.02–1.29)]. Taking lipid-lowering drugs (LLD) was associated with LDL-C < 2.6 mmol/L [OR 2.1 (95% CI 1.05–4.19)] and Lp(a) < 30 mg/dL [OR 0.48 (95% CI 0.25–0.93)]. Physical activity was related to LDL-C < 2.6 mmol/L [OR 2.02 (95% CI 1.02–3.98)]. Higher abdominal circumference was associated with decreased risk of TG < 1.7 mmol/L [OR 0.96 (95% CI 0.93–0.99)]. Elevated lipid parameters were related to age, gender, material status, BMI, history of DM, and hypertension. Adequate control was associated with age, education, physical activity, LLD, history of DM, and abdominal circumference.

Section: Discussionmentioning

confidence: 99%

Determinants of Lipid Parameters in Patients without Diagnosed Cardiovascular Disease—Results of the Polish Arm of the EUROASPIRE V Survey

Ratajczak

Kubica

et al. 2023

JCM

Self Cite

“…The primary care arm of the EUROASPIRE V registry was carried out in 78 primary care centers in 16 coun-tries (Bosnia and Herzegovina, Bulgaria, Croatia, the Czech Republic, Egypt, Greece, Kazakhstan, Kyrgyzstan, Lithuania, Poland, Portugal, Romania, Russia, Sweden, Ukraine and the United Kingdom) during 2017-2018 [11]. Data collection was conducted by trained research staff, who reviewed patient medical records, interviewed and examined the patients using standardized methods in all centers [12,13]. Self-reported information on adherence to medication was obtained with the MAQ.…”

Section: Discussionmentioning

confidence: 99%

Two different approaches to assess adherence to medication in Polish cohort of the EUROASPIRE V registry

Kubica

Medical Research Journal

Kasprzak

et al. 2022

Self Cite

Introduction:The implementation of guidelines on cardiovascular disease (CVD) prevention in patients at high risk of developing CVD was assessed in the EUROASPIRE V registry.Aim of the study: This study was designed to compare a simple self-reported quantitative assessment of adherence to medication using the Medication Adherence Questionnaire (MAQ) with a qualitative evaluation based on the Adherence in Chronic Disease Scale (ACDS) in the Polish cohort of the EUROSPIRE V registry. Material and methods:The study was performed in 200 patients (133 women and 67 men) with an average age of 51.49 (13.63) years and a history of hypertension, hypercholesterolemia or diabetes, but without prior cardiovascular events. Pharmacological treatment was applied in 127 patients (63.5%) with hypertension, 90 (45%) with hypercholesterolemia, and 31 (15.5%) with diabetes.Results: According to the MAQ, high adherence to medication (100% or 90%) was declared by 67.7% of patients, while medium (75% or 50%) and low adherence (< 50% or 0%) by 9.7% and 22.6%, respectively. The adherence assessed with the ACDS, was high in 38.7%, medium in 44.8%, and low in 16.5% of patients. A remarkable inconsistency between ACDS and MAQ responses was found. The MAQ and the ACDS rendered consistent results in 44.8% of patients (111 out of 148), while in the remaining 55.2% (137 out of 248) of patients the results were discordant. Conclusions:The assessment of medication adherence based on patient declarations used in the EU-ROASPIRE V registry is likely to overestimate the frequency of high adherence.

“…Successful implementation of the treatment plan, expressed by a high adherence of patients to therapy, is to be ensured by education and motivation of patients and joint treatment decision-making between healthcare professionals and patients [12][13][14][15][16][17]. This aspect of preventive measures appears to be particularly important as previous studies have shown that treatment failures both in primary and secondary prevention are due to the decreasing implementation of the treatment plan over time [18][19][20][21][22][23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk assessment based on SCORE and SCORE2

Rzepka-Cholasińska

Kasprzak

Medical Research Journal

et al. 2022

Self Cite

Introduction:The 2021 European Society of Cardiology (ESC) guidelines on cardiovascular disease prevention introduced significant changes compared to the previous 2016 edition. Particular attention should be paid to the stepwise approach to treating patients with cardiovascular risk factors, based on individual risk stratification. The SCORE scale previously recommended for risk assessment and its Polish adaptation Pol-SCORE have been replaced by SCORE2 and SCORE2-OP in the latest guidelines.The aim of the study: The aim of this study is a parallel cardiovascular risk assessment with Pol-SCORE and SCORE2 in the same patient population.Material and methods: The study included 159 patients aged 40 to 70 years without prior cardiovascular events that were diagnosed with hypertension or hypercholesterolemia between 6 and 24 months before the start of the study. Patients with diabetes mellitus, chronic kidney disease, and familial hypercholesterolemia were excluded from the study. Results:The 10-year risk of cardiovascular event (SCORE2) was twice as high as the risk of cardiovascular death (Pol-SCORE). In the Pol-SCORE scale, most patients were at moderate risk (65.41%), while based in the SCORE2 scale the dominant group was in the low-to-moderate risk category (49.06%). Among the patients with moderate risk of cardiovascular death (Pol-SCORE), low-to-moderate, high, and very high CVD risk groups (SCORE2) were reported. In other cases, the risk assessments of cardiovascular death and cardiovascular event appear to be consistent. This observation is confirmed by the strong positive correlation (R = 0.7493; p < 0.0001) between the Pol-SCORE and SCORE2 scales.Conclusions: Cardiovascular risk assessments based on the SCORE and SCORE2 scales are broadly consistent, but in individual cases, the results fall into radically different risk categories.