Efficacy of primary prevention for atherosclerosis-induced diseases in patients with high cardiovascular risk in Russia and other European countries (Part 1)

Relevance. Evaluation of the effectiveness of risk management in persons with high cardiovascular risk is an important element in reducing the death rate of the population from cardiovascular diseases (CVD). Aim. Analysis of the prevalence and level of risk factors control in patients with high CV risk CVD from the Russian centers of the primary care unit of the EUROASPIRE IV study in comparison with the general population of the study. Materials and methods. In this cross-sectional study, 14 European countries, including the Russian Federation, participated. Patients aged 18 to 79 years were included in the study, without clinical manifestations of atherosclerosis, who were prescribed antihypertensive therapy and/or lipid lowering therapy and/or treatment for diabetes between the ages of ≥6 months and <3 years before switching on. The study protocol included analysis of medical records and a visit-interview using a specially designed structured questionnaire on the main aspects of lifestyle (smoking, nutrition, physical activity, psychosocial factors), taking medications and adhering to other recommendations. Anthropometric data, blood pressure, concentration of carbon monoxide (CO) in the exhaled air were also recorded during the interview, and venous blood was taken to determine the levels of lipids, glucose and glycated hemoglobin (HbA_1c). All patients without diabetes in the absence of fasting hyperglycaemia ≥11.1 mmol/l conducted an oral glucose tolerance test. Results. In total, 505 patients with known high CV risk were examined in Russian centers and 405 interviews took place (71.6% of women). The prevalence of smoking in the Russian cohort and in the general population of the study was 17.8 and 16.6%, obesity - 56.6 and 43.5%, diabetes - 18.7 and 27.7%, low physical activity - 53.2 and 68.5%, respectively. Support received by patients with smoking quitting was clearly insufficient and rarely included medical therapy. The frequency of reaching the target level of blood pressure on the background of therapy was 68.1 and 42.8%, respectively, and the target level of LDL-C was 26.2 and 32.7%. HbA_1c <7% was reported in 64.3% of patients with diabetes in the Russian cohort and 58.5% in the study as a whole. The proportion of patients whose diabetes was detected only during the visit-interview was 26.4% and 21.8%, respectively. Conclusion. The different components of cardiovascular prevention in Russia and in the general population of the study had some differences, while in some areas, in particular in the control of blood pressure, Russian patients with BP achieved even better results than in Europe as a whole. On the contrary, the situation in Russian centers was worse with regard to the prevalence of overweight and obesity in patients with BP, control of blood lipid levels, as well as detection rates not previously diagnosed with diabetes.

многоцентровое исследование, первичная профилактика, высокий сердечно-сосудистый риск, multi-center study, primary prevention, high cardiovascular risk

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