Current cardiovascular risk management patterns with special focus on lipid lowering in daily practice in Switzerland

BackgroundDiabetes is a stronger risk factor for cardiovascular complications in women than men.AimTo evaluate whether there are sex differences in cardiovascular risk management in patients with diabetes in primary care.Design & settingA cross-sectional study was undertaken using data from 12 512 individuals with diabetes within the Dutch Julius General Practitioners Network (JGPN) from 2013.MethodLinear and Poisson regression analyses were used to assess sex differences in risk factor levels, assessment, treatment, and control.ResultsNo sex differences were found in HbA1c levels and control, while small differences were found for cardiovascular risk management. Blood pressure levels were higher (mean difference [MD] 1.09 mmHg; 95% confidence intervals [CI] = 0.41 to 1.77), while cholesterol levels (MD -0.38 mmol/l; 95% CI = -0.42 to -0.34) and body mass index ([BMI] MD -1.79 kg/m2; 95% CI = -2.03 to 1.56) were lower in men than women. Risk factor assessment was similar between sexes, apart from high-density lipoprotein cholesterol (HDL-c), which was more commonly assessed in women (risk ratio [RR] 1.16; 95% CI = 1.13 to 1.20). Among those with a treatment indication for prevention, women with cardiovascular disease (CVD) were less likely to receive lipid-lowering drugs (RR 0.84; 95% CI = 0.76 to 0.93) than men, while women without CVD were more likely to receive lipid-lowering drugs (RR 1.16; 95% CI = 1.04 to 1.2). Among those treated, women were more likely to achieve systolic blood pressure (SBP) control (RR 1.06; 95% CI = 1.02 to 1.10) and less likely to achieve low-density lipoprotein cholesterol (LDL-c) control (RR 0.88; 95% CI = 0.85 to 0.91) than men.ConclusionIn this Dutch primary care setting, sex differences in risk factor assessment and treatment of people with diabetes were small. However, women with diabetes were less likely to achieve control for LDL-c and more likely to achieve blood pressure control than men with diabetes.

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Rheumatoid arthritis as cardiovascular risk factor: an update

Romanian Journal of Cardiology ◽

10.47803/rjc.2020.30.4.576 ◽

2021 ◽

Vol 30 (4) ◽

pp. 576-582

Author(s):

Calin D. Popa

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Risk Management ◽

Risk Factor ◽

Cardiovascular Risk ◽

Cardiovascular Diseases ◽

Cardiovascular Risk Factor ◽

Independent Risk Factor ◽

Daily Practice ◽

Cardiovascular Risk Management

Rheumatoid arthritis (RA) patients have a 1.5 – 2.5 higher chance to develop cardiovascular diseases (CVD), which in turn represent the most important cause of mortality and the most frequent comorbidity in these patients. Chronic inflammation crucially contributes to that, either as an independent risk factor or as a modulator of traditional cardiovascular (CV) risk factors, such as dyslipidemia and hypertension. The cardiovascular risk management (CVRM) is therefore essential in these patients. The implementation of it in the daily practice is quite challenging and requires a good networking between different specialists (rheumatologist, cardiologist, internist) and the general practitioners (GPs), and may get various forms of organization depending on region and locations.

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