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. 2014 Jan;46(1):15-24.
doi: 10.1016/j.aprim.2013.06.004. Epub 2013 Dec 9.

Population prevalence and control of cardiovascular risk factors: what electronic medical records tell us

Arantxa Catalán-Ramos  1 , Jose M Verdú  2 , María Grau  3 , Manuel Iglesias-Rodal  4 , José L del Val García  5 , Alicia Consola  6 , Eva Comin  7 ; @GPC-ICS Group
Collaborators, Affiliations

Population prevalence and control of cardiovascular risk factors: what electronic medical records tell us

Arantxa Catalán-Ramos et al. Aten Primaria. 2014 Jan.

Abstract
in English, Spanish

Objective: To analyze the prevalence, control, and management of hypertension, hypercholesterolemia, and diabetes mellitus type 2 (DM2).

Design: Cross-sectional analysis of all individuals attended in the Catalan primary care centers between 2006 and 2009.

Location: History of cardiovascular diseases, diagnosis and treatment of hypertension, hypercholesterolemia, DM2, lipid profile, glycemia and blood pressure data were extracted from electronic medical records. Age-standardized prevalence and levels of management and control were estimated.

Participants: Individuals aged 35-74 years using primary care databases.

Main measures: A total of 2,174,515 individuals were included (mean age 52 years [SD 11], 47% men).

Results: Hypertension was the most prevalent cardiovascular risk factor (39% in women, 41% in men) followed by hypercholesterolemia (38% and 40%) and DM2 (12% and 16%), respectively. Diuretics and angiotensin-converting enzyme inhibitors were most often prescribed for hypertension control (<140/90mmHg, achieved in 68% of men and 60% of women treated). Hypercholesterolemia was controlled (low-density lipoprotein cholesterol <130mg/dl) in just 31% of men and 26% of women with no history of cardiovascular disease, despite lipid-lowering treatment, primarily (90%) with statins. The percentage of women and men with DM2 and with glycated hemoglobin <7% was 64.7% and 59.2%, respectively; treatment was predominantly with oral hypoglycemic agents alone (70%), or combined with insulin (15%).

Conclusions: Hypertension was the most prevalent cardiovascular risk factor in the Catalan population attended at primary care centers. About two thirds of individuals with hypertension or DM2 were adequately controlled; hypercholesterolemia control was particularly low.

Objetivos: Analizar la prevalencia, control y manejo de la hipertensión arterial, hipercolesterolemia y diabetes mellitus tipo 2.

Diseño: Análisis transversal de todos los individuos atendidos en centros de atención primaria entre 2006 y 2009.

Emplazamiento: Se extrajo de la historia clínica electrónica los antecedentes de enfermedad cardiovascular, el diagnóstico y tratamiento de la hipertensión arterial, hipercolesterolemia, diabetes mellitus tipo 2, el perfil lipídico, la glicemia y la presión arterial. Las prevalencias y las variables de manejo y control se estandarizaron por edad.

Participantes: Individuos de 35 a 74 años registrados en las bases de datos de atención primaria.

Mediciones principales: Se analizaron registros de 2.174.515 de individuos (47% hombres, edad media 52 años (DE 11)).

Resultados: La hipertensión arterial fue el factor de riesgo más prevalente (39% en mujeres y 41% en hombres), seguido de la hipercolesterolemia (38% y 40%) y la diabetes mellitus tipo 2 (12% y 16%), respectivamente. Los diuréticos y los inhibidores de la enzima convertidora de angiotensina fueron los fármacos más frecuentemente recetados para el control de la presión arterial (68% de hombres y 60% de mujeres presentaron valores <140/90 mmHg). Sólo el 31% de los hombres y el 26% de las mujeres sin antecedentes de enfermedad cardiovascular presentaron hipercolesterolemia controlada (colesterol de las lipoproteínas de baja densidad <130 mg/dl), a pesar del porcentaje de tratamiento con estatinas (90%). EL porcentaje de mujeres y hombres con diabetes mellitus tipo 2 y hemoglobina glicada <7% era de 64.7% y 59.2%, respectivamente; el tratamiento se realizó predominantemente con antidiabéticos orales únicamente (70%) o asociados con insulina (15%).

Conclusiones: La hipertensión arterial fue el factor de riesgo cardiovascular más prevalente en población catalana atendida en centros de atención primaria. Alrededor de dos tercios de los individuos con hipertensión arterial o diabetes mellitus tipo 2 estaban adecuadamente controlados; mientras que el control de la hipercolesterolemia fue especialmente bajo.

Keywords: Atención Primaria; Diabetes Mellitus tipo 2; Diabetes mellitus type 2; Electronic Health Records; Hipercolesterolemia; Hipertensión; Historia clínica electrónica; Hypercholesterolemia; Hypertension; Prevalence; Prevalencia; Primary health care.

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Figures

None
General outline of the study: Cross-sectional design. All individuals aged 35 to 74 years attended in the primary care centers of the Catalan Institute of Health from January 2006 through December 2009 were included.
Figure 1
Figure 1
Distribution of the population by 5-year age groups in the study sample (Panel A) and in Catalonia (Panel B).
See this image and copyright information in PMC

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