International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis.
By Deepak L. Bhatt, P. Steg, E. Ohman, A. Hirsch, Y. Ikeda, J. Mas, S. Goto, C. Liau, A. Richard, J. Röther and 1 more. Journal of the American Medical Association (JAMA), 2006
1,620 citations recorded by the source corpus.
CONTEXT Atherothrombosis is the leading cause of cardiovascular morbidity and mortality around the globe. To date, no single international database has characterized the atherosclerosis risk factor profile or treatment intensity of individuals with atherothrombosis. OBJECTIVE To determine whether atherosclerosis risk factor prevalence and treatment would demonstrate comparable patterns in many countries around the world. DESIGN, SETTING, AND PARTICIPANTS The Reduction of Atherothrombosis for Continued Health (REACH) Registry collected data on atherosclerosis risk factors and treatment. A total of 67,888 patients aged 45 years or older from 5473 physician practices in 44 countries had either established arterial disease (coronary artery disease [CAD], n = 40,258; cerebrovascular disease, n = 18,843; peripheral arterial disease, n = 8273) or 3 or more risk factors for atherothrombosis (n = 12,389) between 2003 and 2004. MAIN OUTCOME MEASURES Baseline prevalence of atherosclerosis risk factors, medication use, and degree of risk factor control. RESULTS Atherothrombotic patients throughout the world had similar risk factor profiles: a high proportion with hypertension (81.8%), hypercholesterolemia (72.4%), and diabetes (44.3%). The prevalence of overweight (39.8%), obesity (26.6%), and morbid obesity (3.6%) were similar in most geographic locales, but was highest in North America (overweight: 37.1%, obese: 36.5%, and morbidly obese: 5.8%; P<.001 vs other regions). Patients were generally undertreated with statins (69.4% overall; range: 56.4% for cerebrovascular disease to 76.2% for CAD), antiplatelet agents (78.6% overall; range: 53.9% for > or =3 risk factors to 85.6% for CAD), and other evidence-based risk reduction therapies. Current tobacco use in patients with established vascular disease was substantial (14.4%). Undertreated hypertension (50.0% with elevated blood pressure at baseline), undiagnosed hyperglycemia (4.9%), and impaired fasting glucose (36.5% in those not known to be diabetic) were common. Among those with symptomatic atherothrombosis, 15.9% had symptomatic polyvascular disease. CONCLUSION This large, international, contemporary database shows that classic cardiovascular risk factors are consistent and common but are largely undertreated and undercontrolled in many regions of the world.
Subfields: Pulmonary and Respiratory Medicine, Surgery
View Paper: https://www.semanticscholar.org/paper/08c4e80cf11bdd7545500baa85dbc24b6dda4e90
How researchers see this paper
The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.
In Pulmonary and Respiratory Medicine
In Surgery
Citations in the corpus
- ESH / ESC Guidelines for the management of arterial hypertension (2013, background): “and BP control is improving slowly or not at all—and this is the case also in secondary prevention.(699,700) Because, in clinical trials, antihypertensive treatment can achieve BP control in the majority of the patients,(701) these data reflect the wide gap that exists”
- One-year cardiovascular event rates in outpatients with atherothrombosis. (2007, background): “However, this would likely result in underestimation of the degree of undertreatment and of the event rates.(4) In addition, the event rates observed in the multiple risk factor population are only applicable to similar patient populations but should probably not be extrapolated to the wider primary”