Trends and current questions of cardiovascular prevention in primary health care

2012 ◽  
Vol 153 (39) ◽  
pp. 1536-1546 ◽  
Author(s):  
István Ilyés ◽  
Zoltán Jancsó ◽  
Attila Simay

Although an impressive progress has been achieved in the treatment of cardiovascular diseases, they are at the top of the mortality statistics in Hungary. Prevention of these diseases is an essential task of the primary health care. Cardiovascular prevention is carried out at primary, secondary and tertiary levels using risk group and population preventive strategies. The two main tasks of primary cardiovascular prevention are health promotion and cardiovascular disease prevention, and its main programs are ensuring healthy nutrition, improving physical training and accomplishing an anti-smoking program. The essential form of secondary prevention is the screening activity of the primary health care. The majority of cardiovascular risk factors can be discovered during the doctor–patient consultation, but laboratory screening is needed for assessing metabolic risks. The official screening rules of the cardiovascular risk factors and diseases are based on diagnostic criteria of the metabolic syndrome; however, nowadays revealing of global cardiometabolic risks is also necessary. In patients without cardiovascular diseases but with risk factors, a cardiovascular risk estimation has to be performed. In primary care, there is a possibility for long term follow-up and continuous care of patients with chronic diseases, which is the main form of the tertiary prevention. In patients with cardiovascular diseases, ranking to cardiovascular risk groups is a very important task since target values of continuous care depend on which risk group they belong to. The methods used during continuous care are lifestyle therapy, specific pharmacotherapy and organ protection with drugs. Combined health education and counselling is the next element of the primary health care prevention; it is a tool that helps primary, secondary and tertiary prevention. Changes needed for improving cardiovascular prevention in primary care are the following: appropriate evaluation of primary prevention, health education and counselling, renewal of the cardiovascular screening system based on the notion of global cardiometabolic risk, creating a unified cardiovascular prevention guideline, and operating primary care cardiovascular prevention within the framework of an integrated prevention system. Orv. Hetil., 2012, 153, 1536–1546.

Author(s):  
Georges Bediang ◽  
Chris Nadège Nganou-Gnindjio ◽  
Yannick Kamga ◽  
Fred-Cyrille Goethe Doualla ◽  
Cheick Oumar Bagayoko ◽  
...  

Objective: This study aimed to evaluate the effectiveness of tele-expertise (tele-ECG) in primary health care in Cameroon for the management of patients with cardiovascular diseases or risk factors. Method: It is a controlled multicenter study carried out in Cameroon’s two health facilities where tele-ECG has been implemented (intervention centers) and two other where telemedicine has been not implemented (control centers). Patients having cardiovascular risk factors or diseases received usual primary health care in the control centers. In contrast, they received usual primary health care and could perform an ECG associated with cardiologists’ remote expertise (tele-ECG) in the intervention centers. The primary outcome was to evaluate the rate of patients’ access to an ECG test and to cardiologist’ expertise. Results and Discussion: Telemedicine is effective for the management of patients with cardiovascular diseases in primary health care. It could improve healthcare providers’ clinical processes, clinical outcomes of patients and their satisfaction.


Author(s):  
Aniandra Karol Gonçalves Sgarbi ◽  
Kátia Gianlupi Lopes ◽  
Márcia Regina Martins Alvarenga

Objective: To analyze the distribution of risk factors for osteopenia and osteoporosis among adults and elderly in primary care. Method: sectional study of quantitative approach. Random sample extracted from registered adults and elderly from the five Family Health Strategy units belonging to an Expanded Family Health and Primary Care Center in Dourados, MS. Data collected between March and December 2015. The sample consisted of 44 adults and 103 elderly, of which only 109 performed all examinations. Body mass index, bone densitometry, serum calcium, 25 serum hydroxyvitamin D and a structured questionnaire were used. Results: The factors that were significantly associated with the risk of osteopenia and osteoporosis (p <0,05) were female gender, alcohol consumption and normal body mass index. Conclusion: the identification of these risk factors made it possible to trace their distribution profile, which will be of great value for carrying out health promotion actions and prevention of these diseases in Primary Health Care.


2019 ◽  
Vol 4 (5) ◽  

Background: Cardiovascular disease (CVD) is common in the general population, affecting many of adults above 40 years of age. It is a multi-factorial disease. Some risk factors; such as family history, gender, ethnicity and age cannot be changed. Other risk factors are modifiable including high blood pressure, high cholesterol and diabetes. Patients will not necessarily develop cardiovascular disease if they have a risk factor. But the more risk factors they have the greater the likelihood that they will, unless protective measures and actions are taken to modify their risk factors and work to prevent them compromising their heart health. Objectives: The objectives of this study were: to evaluate the adherence of major primary health care centers to the WHO-PEN Protocol 1, Package of essential noncommunicable (PEN) disease interventions for primary health care, recommendations;and to provide more accurate estimate of cardiovascular risk using hypertension, type 2 diabetes mellitus and tobacco use as entry points. Methods: A cross-sectional study involving 200 patients who were already diagnosed with NCDs was conducted atprimary health care centers. Data was collected retrospectively using a self-designed questionnaire based on the WHO- PEN checklist. Patients’ files were selected randomly. Results: Based on the analysis of whole cohort (200 cases). The prevalence of type 2 diabetes was 39% and hypertension was 28.5%, whereas 32.5% had both. There were only 17 smokers among patients representing 8.5% of the sample. Using WHO/ISH, WHO/International Society of Hypertension, Risk prediction charts; half of patients were in the tenyear cardiovascular risk category of less than 10%. On the other hand, 5% had a ten-year cardiovascular risk over 40%.49% of patients had a first-degree family history of heart disease? All patients were counseled on diet, exercise and smoking cessation. Conclusion: These results demonstrate high adherence to the WHO-PEN protocol in these two centers reflecting a high quality of care and follow-up. Furthermore, the medical records were fully filled with adequate information for each item. However, there were some deficiencies in the risk estimation, which should be documented for better counseling for patients with high risk.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Jozwiak ◽  
K Studzinski ◽  
T Tomasik ◽  
A Windak ◽  
M Banach

Abstract Background Cardiovascular disease (CVD) is currently one of the leading cause of mortality in the European Union. Well-established, modifiable cardiovascular (CV) risk factors include hypertension (HTN), hypercholesterolaemia, diabetes mellitus (DM), obesity, low activity levels, poor diet and smoking. There are no current estimates on the prevalence of CV risk factors among Polish patients solely in the primary care setting. Methods A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the 4th quarter of 2015 and 1st and 2nd quarters of 2016. 438 primary care physicians enrolled 13,724 adult patients that sought medical care for any medical reason in primary health care practices. Results Nearly 19% of men and approximately 12% of women had CVD. Over 60% of the recruited patients had HTN, &gt;80% had dyslipidaemia and &lt;15% of patients were previously diagnosed with DM. All of these disorders were more frequent in men. Overweight and obesity were present in more than 75% of patients with 80% of them exceeding the waist circumference norm for the European population. Slightly less than half of the patients were current smokers or had smoked in the past. Patients with CVD had significantly higher blood pressure and glucose levels but lower low density lipoprotein-cholesterol level (LDL-C). In patients with CVD, HTN and dyslipidaemia were twice as frequent and DM three times more so than in patients without it (Figure 1). Conclusions The incidence of CVD and CV risk factors among patients attending primary healthcare in Poland is high. CVD is more common in men than in women. The most common CV risk factors are excess waist circumference, dyslipidaemia and HTN. Family physicians working in primary health care, as well as health authorities should conduct activities to prevent, diagnose early and treat CVD in the primary health care population. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): The present study was an initiative of the Polish Lipid Association (PoLA) and the College of Family Physician in Poland (CFPiP). The present study was funded by an unrestricted educational grant from Valeant.


2002 ◽  
Vol 20 (4) ◽  
pp. 224-229 ◽  
Author(s):  
Jan Cederholm ◽  
Peter M. Nilsson ◽  
Carl-Peter Anderberg ◽  
Lars Fröberg ◽  
Ulla Petersson

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