Managing Cardiovascular Risk Factors: The Gap between Evidence and Practice

Turnbull, Fiona

doi:10.1371/journal.pmed.0020131

Cited by 15 publications

(13 citation statements)

References 9 publications

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“…Despite the clinical significance of hypertension and dyslipidemia, the global prevalence of each disease still remains high and is expected to increase continuously as the prevalence increases with age . Although lipid‐lowering agents and antihypertensive agents are effective treatment methods to achieve the target levels, the rate of well‐controlled patients is still low . In one study, only 9% of American hypertensive patients with dyslipidemia achieved the target levels for BP and lipid profile .…”

Section: Introductionmentioning

confidence: 99%

“…11 Although lipid-lowering agents and antihypertensive agents are effective treatment methods to achieve the target levels, the rate of well-controlled patients is still low. [12][13][14] In one study, only 9% of American hypertensive patients with dyslipidemia achieved the target levels for BP and lipid profile. 8 This suboptimal situation may be partially due to poor compliance.…”

Section: Introductionmentioning

confidence: 99%

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A randomized, double‐blind clinical trial to evaluate the efficacy and safety of a fixed‐dose combination of amlodipine/rosuvastatin in patients with dyslipidemia and hypertension

Kim

Chang

Cho

et al. 2020

J of Clinical Hypertension

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This multicenter, randomized, double‐blind, parallel‐group phase III clinical trial aimed to investigate the efficacy and safety of a rosuvastatin + amlodipine combination compared with that of rosuvastatin or amlodipine monotherapy in hypertensive patients with dyslipidemia. A total of 106 patients of 15 institutions in Korea were randomly assigned to 1 of 3 treatment groups: rosuvastatin 20 mg + amlodipine 10 mg, amlodipine 10 mg, or rosuvastatin 20 mg. After 8 weeks of treatment, the mean ± SD of change in mean sitting systolic blood pressure (msSBP) was −22.82 ± 12.99 mm Hg in the rosuvastatin + amlodipine group, the most decreased among the treatment groups. The percentage of patients whose msSBP decreased ≥20 mm Hg or msDBP decreased ≥10 mm Hg was also highest in this group (74.29%). The mean ± SD percentage change in low‐density lipoprotein cholesterol (LDL‐C) level from baseline after 8 weeks was −52.53% ± 11.21% in the rosuvastatin + amlodipine group, the most decreased among the treatment groups. More patients in the rosuvastatin + amlodipine group achieved their target LDL‐C goal at 8 weeks, compared with the other treatment groups (97.14%). No serious adverse events or adverse drug reactions were observed in all groups. In hypertensive patients with dyslipidemia, combination treatment with rosuvastatin 20 mg + amlodipine 10 mg effectively reduced blood pressure and LDL‐C levels while maintaining safety.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A randomized, double‐blind clinical trial to evaluate the efficacy and safety of a fixed‐dose combination of amlodipine/rosuvastatin in patients with dyslipidemia and hypertension

Kim

Chang

Cho

et al. 2020

J of Clinical Hypertension

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“…Only a minority of people with cardiovascular risk factors (CVRF) who qualify for prophylactic interventions to lower their risk is treated adequately [16,17]. Possible explanations are low adherence of doctors to guidelines and ineffective risk communication between doctors and patients [18]. Furthermore, cardiovascular risk is often perceived inappropriately by primary care patients, leading to over- or underestimation of the risk.…”

Section: Introductionmentioning

confidence: 99%

How do family physicians communicate about cardiovascular risk? Frequencies and determinants of different communication formats

et al. 2011

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BackgroundPatients understand information about risk better if it is communicated in numerical or visual formats (e.g. graphs) compared to verbal qualifiers only. How frequently different communication formats are used in clinical primary care settings is unknown.MethodsWe collected socioeconomic and patient understanding data using questionnaires and audio-recorded consultations about cardiovascular disease risk. The frequencies of the communication formats were calculated and multivariate regression analysis of associations between communication formats, patient and general practitioner characteristics, and patient subjective understanding was performed.ResultsIn 73% of 70 consultations, verbal qualifiers were used exclusively to communicate cardiovascular risk, compared to numerical (11%) and visual (16%) formats. Female GPs and female patient's gender were significantly associated with a higher use of verbal formats compared to visual formats (p = 0.001 and p = 0.039, respectively). Patient subjective understanding was significantly higher in visual counseling compared to verbal counseling (p = 0.001).ConclusionsVerbal qualifiers are the most often used communication format, though recommendations favor numerical and visual formats, with visual formats resulting in better understanding than others. Also, gender is associated with the choice of communication format. Barriers against numerical and visual communication formats among GPs and patients should be studied, including gender aspects. Adequate risk communication should be integrated into physicians' education.

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“…However, despite the availability of many safe and efficacious treatments for lowering BP and lipids, the screening, diagnosis, and treatment rates of patients requiring antihypertensive and lipid-lowering therapy are low. [18][19][20][21][22][23][24] One approach to help patients achieve goals for both BP and lipid disorders is the use of combination therapy to simultaneously target more than one CV risk factor. 8 Both amlodipine, a calcium channel blocker (CCB), and atorvastatin, a statin, have proven clinical benefits in the treatment of HTN and DYS, respectively, and have been shown to reduce CV events.…”

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confidence: 99%

Efficacy and Safety of Coadministered Amlodipine and Atorvastatin in Patients With Hypertension and Dyslipidemia: Results of the AVALON Trial

Messerli

Bakris²,

Ferrera³

et al. 2006

J of Clinical Hypertension

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Managing Cardiovascular Risk Factors: The Gap between Evidence and Practice

Abstract: There are clear evidence-based guidelines for managing patients at risk of cardiovascular disease, and yet many doctors don't follow these guidelines.

Cited by 15 publications

References 9 publications

A randomized, double‐blind clinical trial to evaluate the efficacy and safety of a fixed‐dose combination of amlodipine/rosuvastatin in patients with dyslipidemia and hypertension

A randomized, double‐blind clinical trial to evaluate the efficacy and safety of a fixed‐dose combination of amlodipine/rosuvastatin in patients with dyslipidemia and hypertension

How do family physicians communicate about cardiovascular risk? Frequencies and determinants of different communication formats

Efficacy and Safety of Coadministered Amlodipine and Atorvastatin in Patients With Hypertension and Dyslipidemia: Results of the AVALON Trial

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