BACKGROUND:
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.
OBJECTIVE:
This a
community-based study aimed to determine the proportion and
prevalence of uncontrolled
cardiovascular risk factors (CRF) in Brazilian
communities.
METHODS:
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.
RESULTS:
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.
CONCLUSION:
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.