International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis
International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis
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DOI：
10.1001/jama.295.2.180
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发表时间：
2006-01-11
影响因子：
120.7
通讯作者：
Zuzarte, K
中科院分区：
文献类型：
--
作者：
Bhatt, DL;Steg, PG;Zuzarte, K
背景动脉粥样硬化血栓形成是地球仪心血管疾病发病率和死亡率的主要原因。到目前为止，没有一个单一的国际数据库的特点动脉粥样硬化危险因素的个人资料或治疗强度与atherothrombosis.Objective要确定是否动脉粥样硬化危险因素的患病率和治疗将证明在许多国家在世界各地的可比patterns.Design，设置，和参与者的动脉粥样硬化血栓形成的持续健康（REACH）注册减少收集动脉粥样硬化危险因素和治疗的数据。来自44个国家的5473名医生的67888名年龄在45岁或以上的患者，冠心病40 258例，脑血管病18 843例，外周动脉疾病，n = 8273）或3个或3个以上动脉粥样硬化血栓形成风险因素（n = 12389）。主要结果指标动脉粥样硬化危险因素的基线患病率，药物使用，结果全球动脉粥样硬化血栓形成患者的危险因素分布相似，高血压（81.8%）、高胆固醇血症（72.4%）和糖尿病（44.3%）的比例较高。超重（39.8%）、肥胖（26.6%）和病态肥胖（3.6%）的患病率在大多数地理区域相似，但在北美最高（超重：37.1%，肥胖：36.5%，病态肥胖：5.8%; P= 3个风险因素，CAD为85.6%），以及其他循证风险降低治疗。目前在已确诊的血管疾病患者中使用烟草的比例很高（14.4%）。治疗不足的高血压（50.0%基线时血压升高）、未诊断的高血糖（4.9%）和空腹血糖受损（36.5%未知为糖尿病）是常见的。在那些有症状的动脉粥样硬化血栓形成，15.9%有症状的多血管diseases.Conclusion这个大型的，国际化的，当代的数据库显示，经典的心血管危险因素是一致的和常见的，但在世界上许多地区在很大程度上治疗和控制不足。
Context Atherothrombosis is the leading cause of cardiovascular morbidity and mortality around the globe. To date, no single international database has characterized the atherosclerosis risk factor profile or treatment intensity of individuals with atherothrombosis.Objective To determine whether atherosclerosis risk factor prevalence and treatment would demonstrate comparable patterns in many countries around the world.Design, Setting, and Participants The Reduction of Atherothrombosis for Continued Health (REACH) Registry collected data on atherosclerosis risk factors and treatment. A total of 67 888 patients aged 45 years or older from 5473 physician practices in 44 countries had either established arterial disease (coronary artery disease [CAD], n = 40 258; cerebrovascular disease, n = 18 843; peripheral arterial disease, n = 8273) or 3 or more risk factors for atherothrombosis (n = 12 389) between 2003 and 2004.Main Outcome Measures Baseline prevalence of atherosclerosis risk factors, medication use, and degree of risk factor control.Results Atherothrombotic patients throughout the world had similar risk factor profiles: a high proportion with hypertension (81.8%), hypercholesterolemia (72.4%), and diabetes (44.3%). The prevalence of overweight (39.8%), obesity (26.6%), and morbid obesity (3.6%) were similar in most geographic locales, but was highest in North America (overweight: 37.1 %, obese: 36.5%, and morbidly obese: 5.8%; P= 3 risk factors to 85.6% for CAD), and other evidence-based risk reduction therapies. Current tobacco use in patients with established vascular disease was substantial (14.4%). Undertreated hypertension (50.0% with elevated blood pressure at baseline), undiagnosed hyperglycemia (4.9%), and impaired fasting glucose (36.5% in those not known to be diabetic) were common. Among those with symptomatic atherothrombosis, 15.9% had symptomatic polyvascular disease.Conclusion This large, international, contemporary database shows that classic cardiovascular risk factors are consistent and common but are largely undertreated and undercontrolled in many regions of the world.