Physicians’ Perception of the Relevance of Cardiovascular Risk Factors in Patients with and without Type 2 Diabetes in Peru

Abstract

Background: Since cardiovascular (CV) disease is one of the principal causes of mortality among Peruvian population, especially in people with type 2 diabetes (T2D), patient´s CV risk factors evaluation should be done as homogenously as possible. The aim of this study was to determinate what was the perception of different specialists in Peru, of CV risk factors in patients with and without T2D. Methods: An on-line questionnaire on a convenient sample of physicians, from different medical specialties, was answered. The questionnaire assessed the physicians’ perception of fourteen CV risk factors in patients with and without T2D, according to three ratings: very important, moderately important, and slightly important. We assessed the differences between medical specialties through graphs and chi-square tests, and also identified the risk factors considered as “very important” with the highest (≥90%) consensus amongst each specialty. Results: A total of 156 physicians responded to the questionnaire, composed by endocrinologists (30%), cardiologists (26%), internists (18%), nephrologists (13%) and general practitioners (13%). In patients with T2D the importance of BMI ≥30, high LDL cholesterol level, triglycerides ≥ 150 mg/dL, and hyperuricemia were statistically different across medical specialties. Likewise In patients without T2D; triglycerides ≥150 mg/dL, hyperuricemia, pre diabetes, and hepatic steatosis. With the exception of general practitioners, consensus on at least one risk factor was attained in all specialties, albeit these risk factors were heterogeneous amongst them. The only risk factor that reached consensus across all specialties was high blood pressure. Conclusion: Hypertension and smoking were the most important CV risk factors in T2D patients valued by the surveyed physicians, followed by levels of LDL-c and albuminuria. Cardiologists as well as endocrinologists, gave the same assessment to CV risk factors. For people without T2D, smoking was recognized as the most important CV risk factor, followed by hypertension and albuminuria.