Assessment of the implementation level of the guidelines for secondary prevention of cardiovascular disease in everyday clinical practice

Abstract

Background: The goal of secondary prevention is to hinder the recurrence of cardiovascular events in patients already diagnosed with cardiovascular diseases.

Aims: We aimed to assess the level of adherence to guidelines for secondary prevention of cardiovascular disease in everyday clinical practice.

Methods: This was a single‑center retrospective analysis of 460 consecutive rehospitalized patients previously diagnosed with coronary artery disease. The presence of main risk factors for cardiovascular disease was analyzed in this cohort.

Results: Overall, 80.7% of patients did not comply with the body mass index recommendations. Among nondiabetic patients, 43.5% exceeded the recommended blood glucose level and 55.5% of diabetic patients exceeded the recommended level of glycated hemoglobin. Total cholesterol level was higher than recommended in 13.5% of patients, the level of low‑density lipoprotein (LDL) cholesterol was exceeded in 78.7% individuals, and the level of triglycerides was over the limit in 30.2% of patients. Systolic and / or diastolic blood pressure higher than or equal to 140/90 mm Hg was recorded in 41.3% of patients. Low level of physical activity was declared by 56.7% of the studied patients and 14.6% of them admitted to being current tobacco smokers. No patient fulfilled all of the main prevention goals (body weight, no smoking, LDL cholesterol level, glucose level, systolic and / or diastolic blood pressure) and in 10.2% of cases none of the above‑mentioned criteria were achieved. Significant difference in the implementation level of the guidelines was found between the sexes, with men showing lower adherence than women.

Conclusions: The level of adherence to the guidelines for secondary prevention of coronary artery disease was extremely low, with men being worse responders than women.