ABSTRACT
Introducción y objetivos. Los pacientes con enfermedad arterial periférica tienen un elevado riesgo de complicaciones cardiovasculares y muerte. Sin embargo, la utilización de tratamientos cardiovasculares preventivos y la consecución de objetivos terapéuticos en esta población es subóptima. No existen datos que permitan conocer cuál es la tasa de utilización de este tipo de fármacos en nuestro país. Métodos. PERIFERICA es un estudio transversal, realizado de mayo a diciembre de 2009 en 440 consultas de atención primaria, medicina interna, cardiología, cirugía vascular, endocrinología y nefrología, repartidas por todo el territorio nacional. Se incluyó a pacientes de 45 o más años, con enfermedad arterial periférica y una analítica sanguínea realizada durante los últimos 6 meses. Se excluyó a los sujetos con enfermedad coronaria o cerebrovascular. Se recogieron diversas variables clínicas, antropométricas y analíticas y el tratamiento recibido. Resultados. Se incluyó a 4.087 pacientes (media de edad, 68 años; el 74% varones). La prevalencia de diabetes (50%) e hipertensión arterial (90%) era muy elevada. El 79% recibía tratamiento hipolipemiante (el 76%, estatinas); el 85,5%, antihipertensivo (el 66%, bloqueadores del sistema renina-angiotensina), y el 83%, antitrombóticos (el 75%, antiagregantes y el 11%, anticoagulantes). Un 30% tenía el colesterol unido a lipoproteínas de baja densidad < 100 mg/dl; el 29,5% tenía controlada la presión arterial y el 74,5% no fumaba. Tan sólo un 8% tenía controlados estos tres factores de riesgo cardiovascular. Conclusiones. A pesar de que existe un elevado número de pacientes con enfermedad arterial periférica que reciben tratamiento mediante fármacos con evidencias sobre la reducción de complicaciones cardiovasculares, el porcentaje de dichos pacientes que alcanza objetivos terapéuticos es muy bajo (AU)
Introduction and objectives. Patients with peripheral artery disease have a high risk of cardiovascular events and death. The rate of prescription of evidence-based cardiovascular therapies and the attainment of therapeutic goals in this population is suboptimal. There are no previous studies evaluating the rate of prescription of these therapies in our country. Methods. PERIFERICA is a cross-sectional study conducted from May to December 2009 in 440 outpatient clinics of general practitioners, internal medicine, cardiology, vascular surgery, endocrinology, and nephrology specialists throughout Spain. Subjects were included if they were aged >=45 years and had peripheral artery disease and a blood sample obtained during the previous 6 months. Patients were excluded if they had coronary or cerebrovascular diseases. Clinical and anthropometric variables and blood analysis were obtained in all participants. Results. In total, 4087 patients were included in the study (mean age, 68 years; 74% men). There was a high prevalence of diabetes (50%) and hypertension (90%); 79% of participants received lipid-lowering drugs (76% statins), 85.5% antihypertensive drugs (66% renin-angiotensin blockers) and 83% antithrombotics (75% antiplatelet drugs and 11% anticoagulants). In addition, 30% of subjects had a low-density lipoprotein cholesterol concentration n<100mg/dL, 29.5% had optimal control of blood pressure, and 74.5% did not smoke. Only 8% had a good control of all of their cardiovascular risk factors. Conclusions. Although a high percentage of subjects with peripheral artery disease receives adequate treatment with evidence-based preventive therapies, the percentage of subjects with good control of all their risk factors is low (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/prevention & control , Risk Factors , /administration & dosage , /therapeutic use , Atherosclerosis/complications , Atherosclerosis/diagnosis , Smoking/epidemiology , Peripheral Arterial Disease/epidemiology , Peripheral Arterial Disease/physiopathology , Cross-Sectional Studies/methods , Cross-Sectional Studies/trends , Cross-Sectional Studies , Primary Health Care/methods , Diabetes Mellitus/prevention & control , Analysis of VarianceABSTRACT
INTRODUCTION AND OBJECTIVES: Patients with peripheral artery disease have a high risk of cardiovascular events and death. The rate of prescription of evidence-based cardiovascular therapies and the attainment of therapeutic goals in this population is suboptimal. There are no previous studies evaluating the rate of prescription of these therapies in our country. METHODS: PERIFERICA is a cross-sectional study conducted from May to December 2009 in 440 outpatient clinics of general practitioners, internal medicine, cardiology, vascular surgery, endocrinology, and nephrology specialists throughout Spain. Subjects were included if they were aged ≥45 years and had peripheral artery disease and a blood sample obtained during the previous 6 months. Patients were excluded if they had coronary or cerebrovascular diseases. Clinical and anthropometric variables and blood analysis were obtained in all participants. RESULTS: In total, 4087 patients were included in the study (mean age, 68 years; 74% men). There was a high prevalence of diabetes (50%) and hypertension (90%); 79% of participants received lipid-lowering drugs (76% statins), 85.5% antihypertensive drugs (66% renin-angiotensin blockers) and 83% antithrombotics (75% antiplatelet drugs and 11% anticoagulants). In addition, 30% of subjects had a low-density lipoprotein cholesterol concentration n<100 mg/dL, 29.5% had optimal control of blood pressure, and 74.5% did not smoke. Only 8% had a good control of all of their cardiovascular risk factors. CONCLUSIONS: Although a high percentage of subjects with peripheral artery disease receives adequate treatment with evidence-based preventive therapies, the percentage of subjects with good control of all their risk factors is low.
