Article

Identification of the four conventional cardiovascular disease risk factors by Dutch general practitioners

Department of Medical Informatics, Erasmus Universiteit Rotterdam, Rotterdam, South Holland, Netherlands
Chest (Impact Factor: 7.13). 10/2005; 128(4):2521-7. DOI: 10.1378/chest.128.4.2521
Source: PubMed

ABSTRACT Detecting and managing the four major conventional risk factors, smoking, hypertension, diabetes mellitus, and hypercholesterolemia, is pivotal in the primary and secondary prevention of cardiovascular disease (CVD).
To assess the preventive activities of general practitioners (GPs) regarding the four conventional risk factors and the associated measurements for cardiovascular risk factors by GPs in relation to the time of the first clinical presence of CVD.
Large longitudinal general practice research database (the Integrated Primary Care Information database) in the Netherlands from September 1999 to August 2003.
Patients > 18 year of age with newly diagnosed CVD with a valid history of at least 1 year before and after the first clinical diagnosis of CVD. Details on conventional risk factors and associated measurements for the four cardiovascular risk factors were assessed in relation to the first clinical diagnosis of CVD.
In total, 157,716 patients met the study inclusion criteria. Of the 2,594 patients with newly diagnosed CVD, at least one of the four investigated risk factors was observed in 76% of women and 73% of men. In 40% of cases, no risk factor was recorded before the date of the first CVD diagnosis. In 16% of cases, no associated measurements were present before the first CVD diagnosis.
In daily practice, GPs seem to focus on the secondary prevention of CVD. Intervention strategies that aim to influence GPs' case finding behavior should focus on increasing the awareness of physicians in performing risk factor-associated measurements in patients who are eligible for the primary prevention of CVD. Further research will have to show the feasibility and effectiveness of such intervention strategies.

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    • "It is recommended to direct cardiovascular prevention efforts at high risk populations and high risk individuals (Manuel et al., 2006; NCEP expert Panel, 2002; Paulweber et al., 2010; Wiersma and Goudswaard, 2007). However, identification of high risk patients in primary care is hampered by inadequate risk factor recording (de Koning et al., 2005; Sheerin et al., 2007; van Wyk et al., 2005) and pharmacological treatment of cardiovascular risk factors is far from optimal (Kotseva et al., 2008). Finally, doctors often are not good in performing health educational tasks, like health counseling (Hulscher et al., 1999; Hulscher et al., 2006; Kedward and Dakin, 2003). "
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