The Attitudes of Physicians Toward Guideline Recommendations for the Management of Dyslipidemia in Clinical Practice - The VIPFARMA ISCP Project.

The aim of this study was to explore the different attitudes of physicians regarding international recommendations for the management of dyslipidemia in routine medical practice. Seven clusters of questions were designed to characterize the surveyed population. Eight hundred ninety-eight physicians answered the survey, 68.3% cardiologists and 40.0% had specialties related to cardiovascular prevention. 29.6% of physicians supported LDL goals above 70 mg/dL in secondary prevention. Acceptance of values lower than 70 mg/dL was associated with greater levels of continuing education (OR 0.64, 95% CI 0.45-0.91; P = 0.014), specialization in preventive cardiology (OR 0.49, 95% CI 0.28-0.88; P = 0.017) or diabetology (OR 0.48, 95% CI 0.24-0.98; P = 0.043). A less aggressive attitude toward the achievement of guideline goals were observed in physicians who considered LDL values higher than 70 mg/dL as the goal in secondary prevention. One-third of physicians in the survey do not follow goals recommended by international guidelines.

Attitudes and Recommendations of Physicians towards Alcohol Consumption and Cardiovascular Health: A Perspective from Argentina.

Despite epidemiological findings of improvements in cardiovascular risk factors with a light-to-moderate intake of alcohol, many misconceptions remain regarding alcohol intake and the risks and benefits of consumption. We sought to examine physician attitudes and recommendations regarding alcohol intake in a cohort of Argentine physicians and to establish their sources of knowledge. An online national survey was distributed through the Argentine Federation of Cardiology (FAC) to cardiologists, internal medicine specialists, general and other subspecialty physicians in Argentina. The survey was completed by 745 physicians, of whom 671 (90%) were cardiologists. In total, 35% of physicians viewed moderate alcohol intake to be beneficial for cardiovascular health, 36% believed only wine offered such benefits, 24% viewed any intake to be harmful, and 5% had other opinions. More than half (57%) self-reported their knowledge came from academic sources. Regarding knowledge of drinking guidelines, only 41% of physicians were aware of the concept of "standard drink". Physicians were generally not comfortable converting standard drinks into other metric units, however men tended to be more comfortable than women (p = 0.052). Physicians were not satisfied with their knowledge of drinking guidelines (3.01 ± 2.73, on a 0⁻10 scale). Physicians were generally comfortable in counselling patients regarding safe limits of consumption (6.22 ± 3.20, on a 0⁻10 scale). Argentine physicians were not satisfied with their knowledge of alcohol consumption guidelines or their understanding of the reported metrics. Only one-third of study participants viewed moderate alcohol intake as beneficial for cardiovascular health. This study shows the necessity to optimize the sources of knowledge.

Comparison of the effects of different magnesium administration times on infarct size.

BACKGROUND: The protection of high magnesium on infarct size remains controversial. OBJECTIVE: To examine the effects of magnesium administered before ischemia or early in reperfusion on infarct size in a rat model of global ischemia METHODS: Isolated rat hearts were submitted to 40 min of normothermic global ischemia and 2 h of reperfusion. After 20 min of stabilization, four protocols were performed: ischemic control (IC) hearts; 15 mM of magnesium chloride administered 15 min before ischemia (MgI); 15 mM of magnesium chloride administered during the first 15 min of reperfusion (MgR); or 15 mM magnesium plus 5 mM calcium (Mg+Ca) before ischemia. Infarct size was measured by triphenyltetrazolium staining. Contractile function was assessed by left ventricular developed pressure and the maximal velocity of rise of left ventricular presssure. RESULTS: The infarct size in IC hearts was 44+/-5%. In MgI and MgR hearts, the infarct diminished to 4.5+/-1.5% and 18+/-4%, respectively. In Mg+Ca hearts, the protection was also obtained (19+/-3%). Myocardial function also improved significantly by magnesium treatment. At the end of reperfusion, left ventricular developed pressure and maximal velocity of rise of left ventricular pressure values were 23+/-6% and 22+/-3% in MgI; and 10+/-3% and 9+/-2.6% in MgR versus 2+/-0.7% and 2.3+/-0.8% in IC hearts, respectively. CONCLUSION: The treatment with magnesium either before ischemia or early in reperfusion has an infarct size limiting effect in a model of global ischemia. This protective effect is partially due to its calcium antagonistic action.