[The use of the Framingham-REGICOR equation in a primary care centre. Impact on primary prevention of cardiovascular diseases].
OBJECTIVE
To evaluate the adequacy of cardiovascular primary prevention by calculating cardiovascular risk (CVR) with 2 different equations and to evaluate the economic impact of the resulting drug expenditure. DESIGN. By means of a transversal study of all the new cases of lipaemia diagnosed, patients were classified in 2 CVR categories (> or =20% and <20%). The Framingham-Wilson (FW) and Framingham-REGICOR (FR) equations were used to analyse the difference between observed treatments (really prescribed) and expected treatments. Costs were compared.


METHODS
Barceloneta PCC, Barcelona, Spain.


METHODS
Ninety-two cases of lipaemia (2002 and 2003) that met the following inclusion criteria: no coronary history, no taking of lipid-lowering drugs, and age between 35 and 74. There were 10 losses in the 92 individuals through lack of a variable for calculating CVR.


RESULTS
According to the clinical criterion, 22 of the 82 patients were treated with medication (26.82%). The expected proportion of patients treated when the FW equation was used was 24.39% (20/82); and was 0% (0/82) with the FR equation. On applying the FW equation, it was seen that 12 of 22 patients treated and 10 of 60 patients not treated did not receive the correct drug treatment. If the mean cost per patient treated and per year at the PCC is applied to the new cases, there is a 9.09% reduction (euro 479.2) for the FW equation and 100% (euro 5271.2) for the FR equation.


CONCLUSIONS
The use of one or other algorithm for calculating CVR entails pertinent differences in clinical practice and expenditure. All patients in primary prevention must receive non-pharmacological treatment.
Parrilla Valero
Fernando
F
Unidad de Vigilancia Epidemiológica Región Centro, Departament de Salut, Terrassa, Barcelona, Spain. parrilla.valero@cofb.net
Segura Benedicto
Andreu
A
Segú Tolsa
José Luis
JL
D000328:Adult; D000368:Aged; D000465:Algorithms; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D003363:Cost Control; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D016527:Drug Costs; D050171:Dyslipidemias / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D017048:Health Care Costs; D006306:Health Surveys; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
D000960:Hypolipidemic Agents