Comprehensive characteristics of patient population and changes of the patient treatment of uncontrolled arterial hypertension and/or dyslipidemia in the real practice of specialists: results of the LipitenCliDec 2 study


Authors: Martin Šatný 1;  Eva Tůmová 1;  Michal Vrablík 1;  Jana Mašková 2;  Jiří Laštůvka 3
Authors‘ workplace: Centrum preventivní kardiologie, III. interní klinika – endokrinologie a metabolismu 1. LF UK a VFN v Praze 1;  EMMES BIOPHARMA GLOBAL s. r. o., Praha 2;  Interní oddělení, Masarykova nemocnice v Ústí nad Labem, o. z, Krajská zdravotní, a. s. 3
Published in: AtheroRev 2022; 7(1): 42-48
Category:

Overview

The LipitenCliDec 2 study, similar to the first version in general practitioner´s outpatient clinics (GP), provides insight into everyday clinical practice, but this time in cardiologist´s and internist´s outpatient clinics. The follow-up was again designed as a multicenter observational study of patients with uncontrolled arterial hypertension (AH) and/or dyslipidemia (DLP), in whom both personal/anthropometric data and laboratory results were initially collected. Non-/pharmacological intervention followed; the AH/DLP control was reevaluated after 3–6 months. Consistent with the first monitoring, we also document better RF control in LipitenCliDec 2 even in a relatively short period of time after the initial intervention, and moreover in the population of far riskier patients compared to GP. Both RFs were controlled in several more times patients after the initial intervention.. AH treatment was a much smaller problem in this study than in GPs, where only 29% of patients did not have well-controlled blood pressure. A modern combination treatment based on current recommendations was correctly chosen. According to DLP control, the situation was similar to GPs, with more than 90% of the most at-risk patients not reaching LDL-cholesterol targets. Modern statins (atorva- or rosuvastatin) have been correctly indicated for the treatment of DLP, but again in relatively low doses; the use of combination therapy was used rather reservedly. There are a number of explanations and they will be further discussed in this article. The LipitenCliDec 2 study also points to the good implementation of the recommended procedures in practice, when appropriate cardioprotective treatment is correctly prescribed, but this is often titrated with excessive caution or combination therapy is not often adequately indicated (especially for DLP treatment). The results of the LipitenCliDec 1 study: AtheroRev 2020; 5 (1): 47–521/2020 and AtheroRev 2020; 5 (2): 117– 123 as well as a comparison of the basic results of both studies: AtheroRev 2021; 6 (3): 151–158 have already been published in previous issues of this journal. The aim of this article is to provide a more detailed description of the population included and a description of the pharmacotherapy changes made.

Keywords:

arterial hypertension – cardiovascular disease – dyslipidemia – cardiovascular risk – cardiovascular prevention


Sources

1. Zemřelí 2018. Praha: ÚZIS ČR 2019. Dostupné z WWW: <https://www.uzis.cz/res/f/008309/demozem2018.pdf>.

2. Vrablík M, Piťha J, Bláha V et al. Stanovisko výboru České společnosti pro aterosklerózu k doporučením ESC/EAS pro diagnostiku a léčbu dyslipidemií z roku 2019. AtheroRev 2019; 4(3): 126–137.

3. Widimský J jr, Filipovský J, Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze – verze 2017. Doporučení České společnosti pro hypertenzi. Hypertenze KV Prevence 2018; 7(Suppl): 2–22.

4. Widimský J. Léčba hypertenze v každodenní praxi. Interní Med 2010; 12(5): 236–246.

5. Vrablík M, Piťha J, Blaha V et al. Stanovisko výboru ČSAT k doporučením ESC/EAS pro diagnostiku a léčbu dyslipidemií z roku 2016. AtheroRev 2017; 2(3): 185–193.

6. Šatný M, Mašková J, Tůmová E et al. Profil pacientů s nekontrolovanou arteriální hypertenzí a/nebo dyslipidemií v primární péči v Česku – studie LipitenCliDec: výsledky 1. fáze. Atherorev 2020, 5(1): 47–52.

7. Šatný M, Tůmová E, Vrablík M et al. Profil pacientů s nekontrolovanou arteriální hypertenzí a/nebo dyslipidemií v primární péči v Česku – studie LipitenCliDec: výsledky 2. fáze. AtheroRev 2020, 5(2): 117–123.

8. Šatný M, Tůmová E, Vrablík M et al. Srovnání profilu a léčby pacientů s nekontrolovanou arteriální hypertenzí a/nebo dyslipidemií v péči specialistů a v primární péči v Česku: srovnání výsledků studie LipitenCliDec 1 a LipitenCliDec 2. AtheroRev 2021; 6(3): 151–158.

9. Mach F, Baigent C, Catapano AL et al. [ESC Scientific Document Group]. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2020; 41(1): 111–188. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehz455>.

10. Kotseva K, Wood D, De Backer G et al. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet 2009; 373(9667): 929–940. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(09)60330–5>.

11. Šatný M, Tůmová E, Vrablík M. LIPIcontrol: daří se zlepšovat úroveň kontroly hlavních rizikových faktorů kardiovaskulárních onemocnění v každodenní praxi? Hypertenze KV Prevence 2018; 7(1): 15–21.

Labels
Angiology Diabetology Internal medicine Cardiology General practitioner for adults
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