Tactics features for managing out-patients with cardiovascular comorbidity in Krasnoyarsk city

Abstract

The aim of the research is to study the structure of cardiovascular continuum within comorbid pathology within outpatient clinic of Krasnoyarsk; to evaluate the quality of out-patients management in accordance with modern clinical guidelines. Material and methods. To conduct a single retrospective analysis, 1928 medical records of Krasnoyarsk cardiovascular out-patients were taken. All the patients consulted local therapists in 2018. Differences were statistically significant at p <0.05. Results. Comorbid pathology is observed in patients with CVD in 87% of cases, and its growth is noted with age. It was revealed that ischemic heart disease (CHD) and obesity are associated with type 2 diabetes mellitus (DM-2). When using antihypertensive therapy, 43.2% of patients achieved blood pressure (BP) values <140/80 mm Hg. In 46.8% of cases, patients who were prescribed statins had total cholesterol (TC) values <5.0 mmol / L. Only 18.5% of patients with DM-2, following lipid-lowering therapy had a total cholesterol level <4.5 mmol / L, that was also registered only in 15.9% of patients with chronic kidney disease (CKD). Heart rate (HR) <80 beats / min was observed in 75% of patients taking drugs of b-blocker group. Conclusion. Cardiovascular comorbidity among patients is widespread and its rates are evidenced to increase with age. Antihypertensive, lipid-lowering and antithrombotic therapy do not fully comply with current clinical guidelines. It is necessary to individualize the approach to patients with combined pathology; to provide comprehensive diagnosis, treatment, and to inform the population on primary and secondary prevention adequately