6533b858fe1ef96bd12b633f

RESEARCH PRODUCT

276 Evaluation of cardiovascular risk and factors associated to risk under-evaluation in general practice

subject

description

Correlation between perceived cardiovascular risk (CVR) by physicians and real CVR is poorly known. Moreover, the underlying question of factors associated to risk misevaluation, especially for patients at high CVR and that could benefit of a lipid lowering therapy (LLT), remains unsolved. Objective and methodology This was an on-line non-interventional study conducted on a sample of 619 general practitioners. The aim was to describe the relation between physicians evaluated CVR and calculated CVR according to risk's scales. All consulting patients’ aged50 years old (YO) were included. Physicians had to complete a questionnaire and to assess patient's CVR on a 3 level scale (low, medium, and high). Framingham and SCORE (low risk Results 13446 patients were included (mean age: 67 YO, male: 48%, LDLc1.3g/L: 46%, LLT: 36%, personal history of CV disease: 16%, smoker: 12%, high blood pressure (HBP): 52%, diabetes: 18%). Population risk is listed below Evaluated (%) Framingham (%) Score (%) Low 40 41 28 Medium 37 24 24 High 23 35 48 Physicians evaluation mismatched with Framigham for 50% of the patients and 27% were under-evaluated. Evaluation mismatched with SCORE for 53% of the patients, 38% were under-evaluated. Within the 25% of the patients having a Framingham score >20% and without a lipid lowering treatment, 70% was under evaluated by physicians. Within the 38% of the patients having a SCORE calculation 5% and without a lipid lowering treatment, 78% were under evaluated. Explanatory factors for under-evaluation in primary prevention according to SCORE OR CI 95% Treated HBP vs no HBP 2,55 2.04–3.19 Gender (male) 2,44 2,16–2,76 LDLc 2,13 1,78–2,55 Smoker 1,82 1,52–2,19 Chronic inflammatory disease 1,19 1,00–1,42 Age 1,16 1,15–1,17 Conclusion This study underlines the mismatch between GP perceived CVR and calculated CVR, especially for high CVR patient. Males, patients with treated HBP and with high LDL-c were at increased risk of CVR under-evaluation.