control rate | Acta Medica Marisiensis

Blood Pressure Control Rates in a Cardiovascular Preventive Ambulatory System 2002–2010

Preg Z¹, Kikeli P¹, Laszlo MI², German-Sallo Marta³, Hubatsch Mihaela¹, Bocicor Andreea-Elena¹

1 Department of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş
2 Procardia Medical Society Tîrgu Mureş
3 Department of Medical Semiology, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş

Introduction: Increasing awareness, treatment and control rates of hypertensive patients is a worldwide problem especially in Central and East European countries.
The objective of the study was to determine the yearly changes in the achievement of treatment targets according to ESC 2003–2007 guidelines for the management of arterial hypertension in a preventive profiled ambulatory cardiology setting.
Patients and method: The study included 6591 hypertensive patients examined between 2002–2010 in the Procardia preventive ambulatory in Târgu Mureș, Romania. The sex distribution of the studied patients was 45.64% male average age 57.45 years, and 54.36% female average age 61.28 years. Patients received individually tailored self control education, lifestyle advice and drug treatment – the primary care providers were informed in detailed medical reports. We studied the yearly achievement of target blood pressure levels. We also analysed the frequency of investigations carried out for the global risk assessment screening for subclinical organ damage. We used “MedPrax” integrated patient data management system as an electronic health record. Statistical analysis was performed with the Open Office Calc programme.
Results: Target blood pressure values (under 140/90 mmHg in non diabetic patients and 130/80 in diabetic patients) were reached in 27.51%. The percentage of patients treated to target increased progressively from 15.25% to 36.29%.
Conclusions: The activity of the studied cardiology ambulatory setting provided a yearly increase in the level of blood pressure target achievement. Further improvement measures are needed to increase blood pressure control rates, with a specific attention to the diabetic patients.

Reducing Global Risk of Ambulatory Assisted Hypertensive Patients – What Could Be Changed in the Practice of a Romanian Preventive Ambulatory System According to New Dyslipidaemia Guidelines?

Preg Z¹, Kikeli P¹, Germán-Salló Márta³, Hubatsch Mihaela¹, Bocicor Andreea-Elena¹, László MI²

1 Department of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Procardia Medical Society, Tîrgu Mureş, Romania
3 Department of Medical Semiology, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Reducing the total cardiovascular risk of hypertensive patients is one of the basic targets in hypertension management. A good lipid control is a major contributor of the global risk reduction.
Purpose: To simulate the impact of the ESC/EAS 2011 guidelines for the management of dyslipidaemias on the lipid management practice of a preventive profiled ambulatory cardiology system.
Methods: The study included all the 7413 hypertensive patients examined between 2002–2011 in a preventive ambulatory system. As a part of the simulation patients were stratified to risk categories according to ESC 2011 guidelines. We compared the frequency of prescribed cholesterol lowering medication with that theoretically indicated based on the new guidelines. The study is based on a retrospective simulation of the theoretical effects of the implementation of the new guidelines in a real patient population.
Results: Risk stratification could be performed in 78.74% of the population. Patients were stratified to very high risk 74.82%, high risk 1.96%, moderate risk 8.66%, and low risk 14.56%. Cholesterol lowering treatment was prescribed for 39.58% of the patients. Very high risk patients were treated more frequently (48.8%), than high (37.0%), moderate (26.5%), or low (16.4%) risk patients. According to the new ESC guidelines theoretical indication for cholesterol lowering treatment has been for 52.07% (3860) of patients. The analysis of the yearly trends in prescribing cholesterol lowering drugs showed an increase from 0% in 2002 to 52.7% in 2011.
Conclusions: A yearly improving trend can be observed in the frequency of indicating cholesterol lowering drugs. The future implementation of the new guideline has the potential impact to assure cholesterol lowering medication indication for another 1980 patients in our sample.