Abstract
BackgroundPatients with high cardiovascular risk are usually cared for in primary care settings. Assessment of the effectiveness of long-time care was a subject of many European studies in the last two decades. This paper aims to present two Hungarian primary care cross sectional surveys and to compare their results to the primary care arms of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) III. and IV. studies.MethodsBetween 2010 and 2011, 679 patients with high cardiovascular risk were recruited in 20 Hungarian primary care practices and 628 patients were selected in 40 practices between 2015 and 2016. The actual national recommendations were used for classification, all based on European guidelines. Achievements of target levels for blood pressure, total-, LDL-and HDL-cholesterols, triglyceride, and HbA1c (in diabetics) were recorded and analyzed. Further cardiovascular risk factors, such as smoking, BMI, waist-circumference were also evaluated.ResultsThere was a statistically significant improvement in the management of blood-pressure and plasma LDL-cholesterol levels among high risk patients, while there was no change in the plasma triglyceride values. The effectiveness of diabetes care deteriorated. In international relation, the management of blood pressure and plasma LDL-cholesterol values were better in Hungary when compared to the results of EUROASPIRE III-IV. studies, while the previous advantage in diabetes care disappeared. A higher proportion of diabetic patients was above the target values in Hungary than the means of the European surveys. There was a higher proportion of smokers in the Hungarian samples, while the proportion of obese and overweight patients was similar to the European sample.ConclusionsPrimary care has a unique role in cardiovascular prevention. Although many of the patients are managed appropriately, there is a need to improve primary care services in Hungary, giving more competences to GPs in prescription and introducing structural changes in the healthcare system.
Highlights
Patients with high cardiovascular risk are usually cared for in primary care settings
Our study group - based on the Hungarian primary care research network - performed a representative nationwide cross-sectional survey in 2010–2011
In the first survey only 37.1 and 30.1% of the patients were below the target threshold
Summary
Patients with high cardiovascular risk are usually cared for in primary care settings. Assessment of the effectiveness of long-time care was a subject of many European studies in the last two decades. Primary and secondary prevention of these morbidities is a top priority of national public health policies in European countries. The first European guideline of the Joint European Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention (JETF) was published in 1994 [1] but the real breakthrough came in 2003 with the third guideline [2], introducing the Systematic Coronary Risk Evaluation (SCORE) method. This guideline defined target values for the management of major risk factors and gave recommendations on lifestyle change and preventive medication. The sixth recommendation of the JETF [3] is applicable, published in 2016
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