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Population prevalence and control of cardiovascular risk factors: What electronic medical records tell us
Affiliation:1. Àmbit d’Avaluació de Farmàcia, Agència de Qualitat i Avaluació Sanitàries de Catalunya, Barcelona, Spain;2. Unitat de Coordinació i Estratègia del Medicament, Direcció Adjunta d’Afers Assistencials, Institut Català de la Salut, Barcelona, Spain;3. Institut Català de la Salut, Barcelona, Spain;4. Universitat Autònoma de Barcelona, Spain;5. IMIM – Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain;6. Institut d’Investigació en Atenció Primària Jordi Gol, Barcelona, Spain;7. Aplicaciones en Informática Avanzada (AIA) S.L., Barcelona, Spain
Abstract:ObjectiveTo analyze the prevalence, control, and management of hypertension, hypercholesterolemia, and diabetes mellitus type 2 (DM2).DesignCross-sectional analysis of all individuals attended in the Catalan primary care centers between 2006 and 2009.LocationHistory of cardiovascular diseases, diagnosis and treatment of hypertension, hypercholesterolemia, DM2, lipid profile, glycemia and blood pressure data were extracted from electronic medical records. Age-standardized prevalence and levels of management and control were estimated.ParticipantsIndividuals aged 35–74 years using primary care databases.Main measuresA total of 2,174,515 individuals were included (mean age 52 years [SD 11], 47% men).ResultsHypertension was the most prevalent cardiovascular risk factor (39% in women, 41% in men) followed by hypercholesterolemia (38% and 40%) and DM2 (12% and 16%), respectively. Diuretics and angiotensin-converting enzyme inhibitors were most often prescribed for hypertension control (<140/90 mmHg, achieved in 68% of men and 60% of women treated). Hypercholesterolemia was controlled (low-density lipoprotein cholesterol <130 mg/dl) in just 31% of men and 26% of women with no history of cardiovascular disease, despite lipid-lowering treatment, primarily (90%) with statins. The percentage of women and men with DM2 and with glycated hemoglobin <7% was 64.7% and 59.2%, respectively; treatment was predominantly with oral hypoglycemic agents alone (70%), or combined with insulin (15%).ConclusionsHypertension was the most prevalent cardiovascular risk factor in the Catalan population attended at primary care centers. About two thirds of individuals with hypertension or DM2 were adequately controlled; hypercholesterolemia control was particularly low.
Keywords:Electronic Health Records  Hypercholesterolemia  Hypertension  Diabetes mellitus type 2  Primary health care  Prevalence  Historia clínica electrónica  Hipercolesterolemia  Hipertensión  Diabetes Mellitus tipo 2  Atención Primaria  Prevalencia
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