■心血管疾病(CVD)的一级预防仍然是一个重大挑战,特别是在低收入和中等收入国家的社区,医疗援助差,受到不同地方的影响,金融,基础设施,和资源相关因素。
■这是一项基于社区的研究,旨在确定巴西社区中不受控制的心血管危险因素(CRF)的比例和患病率。
■EPICO研究是一项观察性研究,横截面,以及以社区诊所为基础的研究。受试者生活在巴西社区,性别和≥18岁,没有中风或心肌梗塞的病史,但至少存在以下心血管危险因素之一:高血压,糖尿病和高胆固醇血症。这项研究是在巴西进行的,包括32个城市的322个基本卫生单位(BHU)。
■总共评估了7724名具有至少一种CRF的受试者,进行了一次临床访问.平均年龄为59.2岁(53.7%>60岁)。66.7%为女性。在总数中,96.2%有高血压,78.8%患有II型糖尿病,71.1%有血脂异常,76.6%的患者超重/肥胖。控制性高血压(定义为<130/80mmHg或<140/90mmHg)在各标准中观察到34.9%和55.5%的患者,服用抗糖尿病药物的患者血糖控制率为29.5%,在那些有血脂异常的人中,他们接受了任何降脂药,只有13.9%的LDL-c达到目标.对于CRF低于1.9%的患者,一旦他们的BP和血糖达到目标,LDL-c<100mg/dL。高教育水平与血压(BP)低于130/80mmHg的目标相关。目标血糖和LDL-c水平与高血压和糖尿病的存在相关。
■在巴西社区诊所,关于大多数一级预防患者,通用报告格式,如BP,血糖,血脂水平控制不佳,大多数患者未达到指南/建议。
Primary prevention of cardiovascular disease (CVD) remains a major challenge, especially in communities of low- and middle-income countries with poor medical assistance influenced by distinct local, financial, infrastructural, and resource-related factors.
This a community-based study aimed to determine the proportion and prevalence of uncontrolled cardiovascular risk factors (CRF) in Brazilian communities.
The EPICO study was an observational, cross-sectional, and community clinic-based study. Subjects were living in Brazilian communities and were of both sexes and ≥18 years old, without a history of a stroke or myocardial infarction but presenting at least one of the following cardiovascular risk factors: hypertension, diabetes mellitus and hypercholesterolemia. The study was carried out in Brazil, including 322 basic health units (BHU) in 32 cities.
A total of 7,724 subjects with at least one CRF were evaluated, and one clinical visit was performed. Mean age was 59.2 years-old (53.7% were >60 years old). A total of 66.7% were women. Of the total, 96.2% had hypertension, 78.8% had diabetes mellitus type II, 71.1% had dyslipidemia, and 76.6% of patients were overweight/obese. Controlled hypertension (defined by <130/80 mmHg or <140/90 mmHg) was observed in 34.9% and 55.5% patients among respective criteria, the rates of controlled blood glucose in patients taking antidiabetic medications was 29.5%, and among those with documented dyslipidemia who received any lipid-lowering medication, only 13.9% had LDL-c on target. For patients presenting three CRF less than 1.9% had LDL-c < 100 mg/dL once their BP and blood glucose were on target. High education level as associated with blood pressure (BP) target of less than 130 / 80mm Hg. The glucose and LDL-c levels on target were associated with the presence of hypertension and diabetes mellitus.
In Brazilian community clinics, regarding most patients in primary prevention, the CRF such as BP, blood glucose, and lipid levels are poorly controlled, with a majority of patients not achieving guidelines/recommendations.