0000000000010953
AUTHOR
Salvador Pita-fernández
Clinical Inertia in Poorly Controlled Elderly Hypertensive Patients: A Cross-Sectional Study in Spanish Physicians to Ascertain Reasons for Not Intensifying Treatment
Clinical inertia, the failure of physicians to initiate or intensify therapy when indicated, is a major problem in the management of hypertension and may be more prevalent in elderly patients. Overcoming clinical inertia requires understanding its causes and evaluating certain factors, particularly those related to physicians.The objective of our study was to determine the rate of clinical inertia and the physician-reported reasons for it.An observational, cross-sectional, multi-center study was carried out in a primary care setting. We included 512 physicians, with a consecutive sampling of 1,499 hypertensive patients with clinical inertia.Clinical inertia was defined when physicians did n…
In the Identification of Cardiovascular Risk With the SCORE Model, Could We Recommend Its Calculation Interchangeably With Total Cholesterol or Atherogenic Index? Concordance Between Total Cholesterol and Atherogenic Index in the SCORE Table
The SCORE table indiscriminately recommends the use of total cholesterol (SCORE-TC) or atherogenic index (SCORE-AI) for calculating cardiovascular (CV) risk. We evaluated reliability and agreement between both methods and the clinical implications for the identification of high CV risk. Observational study (n = 8942) in a 40- to 65-year-old population. Spearman’s Rho correlation was 0.987 (P < .001), the agreement intraclass correlation coefficient was 0.671 (IC 95% 0.413–0.796; with Bland–Altman’s method, the average of the differences between models was 0.74. Kappa index was poor, 0.297 (P < .001) and positive specific agreement was 0.31. Discrepancies fitted individuals with high CV risk…
Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study
Introduction The potential impact of targeting different components of an adverse lipid profile in populations with multiple cardiovascular risk factors is not completely clear. This study aims to assess the association between different components of the standard lipid profile with allcause mortality and hospitalization due to cardiovascular events in a high-risk population. Methods This prospective registry included high risk adults over 30 years old free of cardiovascular disease (2008-2012). Diagnosis of hypertension, dyslipidemia or diabetes mellitus was inclusion criterion. Lipid biomarkers were evaluated. Primary endpoints were all-cause mortality and hospital admission due to corona…
En la identificación del riesgo cardiovascular con el modelo SCORE, ¿se puede recomendar su cálculo indistintamente con colesterol total o índice aterogénico? Concordancia entre el colesterol total y el índice aterogénico en la tabla SCORE
Resumen La escala SCORE recomienda indistintamente dos metodos para el calculo del riesgo cardiovascular: uso de colesterol total (CT) o del indice aterogenico (IA). Se evalua la correlacion entre ambos y la concordancia en la identificacion del riesgo cardiovascular elevado. Estudio observacional en poblacion de 40-65 anos. Se calcula el coeficiente de correlacion intraclase (CCI) de acuerdo, el metodo de Bland-Almand (MBA) y el indice Kappa (IK). El CCI intraclase fue de 0,671 (intervalo del confianza [IC] del 95%, 0,413-0,796; p
Rationale and methods of the cardiometabolic valencian study (escarval-risk) for validation of risk scales in mediterranean patients with hypertension, diabetes or dyslipidemia
Abstract Background The Escarval-Risk study aims to validate cardiovascular risk scales in patients with hypertension, diabetes or dyslipidemia living in the Valencia Community, a European Mediterranean region, based on data from an electronic health recording system comparing predicted events with observed during 5 years follow-up study. Methods/Design A cohort prospective 5 years follow-up study has been designed including 25000 patients with hypertension, diabetes and/or dyslipidemia attended in usual clinical practice. All information is registered in a unique electronic health recording system (ABUCASIS) that is the usual way to register clinical practice in the Valencian Health System…
A cardiovascular educational intervention for primary care professionals in Spain: positive impact in a quasi-experimental study
Background Routine general practice data collection can help identify patients at risk of cardiovascular disease. Aim To determine whether a training programme for primary care professionals improves the recording of cardiovascular disease risk factors in electronic health records. Design and setting A quasi-experimental study without random assignment of professionals. This was an educational intervention study, consisting of an online-classroom 1-year training programme, and carried out in the Valencian community in Spain. Method The prevalence rates of recording of cardiovascular factors (recorded every 6 months over a 4-year period) were compared between intervention and control group. …