BACKGROUND: Data on outpatient care provided to patients at high cardiovascular risk in Brazil are insufficient. OBJECTIVE: To describe the profile and document the clinical practice of outpatient care in patients at high cardiovascular risk in Brazil, regarding the prescription of evidence-based therapies. METHODS: Prospective registry that documented the ambulatory clinical practice in individuals at high cardiovascular risk, which was defined as the presence of the following factors: coronary artery disease, cerebrovascular and peripheral vascular diseases, diabetes, or those with at least three of the following factors: hypertension, smoking, dyslipidemia, age > 70 years, family history of coronary artery disease, chronic kidney disease or asymptomatic carotid artery disease. Basal characteristics were assessed and the rate of prescription of pharmacological and non-pharmacological interventions was analyzed. RESULTS: A total of 2364 consecutive patients were included, of which 52.2% were males, with a mean age of 66.0 years (± 10.1). Of these, 78.3% used antiplatelet agents, 77.0% used statins and of patients with a history of myocardial infarction, 58.0% received beta-blockers. Concomitant use of these three classes of drugs was 34%; 50.9% of hypertensive, 67% of diabetic and 25.7% of dyslipidemic patients did not achieve the goals recommended by guidelines. The main predictors of prescription therapies with proven benefit were centers with a cardiologist and history of coronary artery disease. CONCLUSION: This national and representative registry identified important gaps in the incorporation of therapies with proven benefit, offering a realistic outlook of patients at high cardiovascular risk.
BACKGROUND: Data on outpatient care provided to patients at high cardiovascular risk in Brazil are insufficient. OBJECTIVE: To describe the profile and document the clinical practice of outpatient care in patients at high cardiovascular risk in Brazil, regarding the prescription of evidence-based therapies. METHODS: Prospective registry that documented the ambulatory clinical practice in individuals at high cardiovascular risk, which was defined as the presence of the following factors: coronary artery disease, cerebrovascular and peripheral vascular diseases, diabetes, or those with at least three of the following factors: hypertension, smoking, dyslipidemia, age > 70 years, family history of coronary artery disease, chronic kidney disease or asymptomatic carotid artery disease. Basal characteristics were assessed and the rate of prescription of pharmacological and non-pharmacological interventions was analyzed. RESULTS: A total of 2364 consecutive patients were included, of which 52.2% were males, with a mean age of 66.0 years (± 10.1). Of these, 78.3% used antiplatelet agents, 77.0% used statins and of patients with a history of myocardial infarction, 58.0% received beta-blockers. Concomitant use of these three classes of drugs was 34%; 50.9% of hypertensive, 67% of diabetic and 25.7% of dyslipidemic patients did not achieve the goals recommended by guidelines. The main predictors of prescription therapies with proven benefit were centers with a cardiologist and history of coronary artery disease. CONCLUSION: This national and representative registry identified important gaps in the incorporation of therapies with proven benefit, offering a realistic outlook of patients at high cardiovascular risk.
Authors: M Julia Machline-Carrion; Rafael Marques Soares; Lucas Petri Damiani; Viviane Bezerra Campos; Bruna Sampaio; Francisco H Fonseca; Maria Cristina Izar; Celso Amodeo; Octávio Marques Pontes-Neto; Juliana Yamashita Santos; Samara Pinheiro do Carmo Gomes; José Francisco Kerr Saraiva; Eduardo Ramacciotti; Pedro Gabriel de Melo Barros E Silva; Renato D Lopes; Nilton Brandão da Silva; Hélio Penna Guimarães; Leopoldo Piegas; Airton T Stein; Otávio Berwanger Journal: JAMA Cardiol Date: 2019-05-01 Impact factor: 14.676
Authors: Pedro Gabriel Melo de Barros E Silva; Otavio Berwanger; Dalton Bertolim Precoma; Margaret Assad Cavalcante; José Fernando Vilela-Martin; Estêvão Lanna Figueiredo; Renato Delascio Lopes; Luiz Carlos Bodanese; Jorge Ilha Guimarães; Jadelson Pinheiro de Andrade; Angelo Amato Vincenzo de Paola; Marcus Vinicius Bolivar Malachias; Luiz Alberto Piva E Mattos; Fernando Bacal; Oscar Pereira Dutra Journal: Arq Bras Cardiol Date: 2021-01 Impact factor: 2.000
Authors: Ricardo Wang; Fernando Carvalho Neuenschwander; Augusto Lima Filho; Celsa Maria Moreira; Elizabete Silva dos Santos; Helder Jose Lima Reis; Edson Renato Romano; Luiz Alberto Piva e Mattos; Otávio Berwanger; Jadelson Pinheiro de Andrade Journal: Arq Bras Cardiol Date: 2014-02-17 Impact factor: 2.000