title: Obstacles to cardiovascular prevention in general practice.
abstract: OBJECTIVE
  In spite of a wide diffusion of the European guidelines for prevention of cardiovascular (CV) diseases, failures in both primary and secondary CV prevention are currently acknowledged. We wanted to uncover obstacles to CV prevention related to the general practitioner's (GP) knowledge and attitudes.
  
  
  RESULTS
  A postal questionnaire was sent to a random sample of GPs from two Belgian provinces. 282 GPs (32%) answered the questionnaire. The proportion of adequate answers was calculated for each item. The main obstacles related to three domains. Regarding awareness of CV burden, 83% of the GPs underestimated the lethality of myocardial infarction and 41% underestimated the prevalence of high CV risk in the adult population. Regarding CV risk assessment, 80% thought that total cholesterol (TC) adequately reflected the individual CV risk; only 55% systematically registered the patient's CV risk factors in the medical record. A tool for global CV risk assessment was never used by 53% of the GPs. Regarding CV therapeutic attitudes, 66% systematically prescribed a lipid-lowering drug to patients with high TC while 62% did not take into account the evidence-based therapeutic targets in type 2 diabetic patients.
  
  
  CONCLUSIONS
  This survey showed that these GPs underestimated the CV burden, lacked a systematic approach to global risk assessment and used to focus on cholesterol treatment rather than on global CV risk management.
authors.affiliation: School of Public Health, Unit of Epidemiology, Université catholique de Louvain, Brussels, Belgium.
authors.forename: Régis
authors.initials: R
authors.lastname: De Muylder
authors.forename: Vincent
authors.initials: V
authors.lastname: Lorant
authors.forename: Dominique
authors.initials: D
authors.lastname: Paulus
authors.forename: Fabienne
authors.initials: F
authors.lastname: Nackers
authors.forename: Michel
authors.initials: M
authors.lastname: Jeanjean
authors.forename: Benoit
authors.initials: B
authors.lastname: Boland
mesh_terms: D001364:Awareness; D001530:Belgium; D002318:Cardiovascular Diseases / Q000517:prevention & control* / Q000523:psychology; D002983:Clinical Competence; D005194:Family Practice / Q000379:methods / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D011795:Surveys and Questionnaires