[Control of risk factor in diabetic patients in secondary prevention. MIRVAS Study].
BACKGROUND
Control of cardiovascular risk factors (CVRF) in secondary prevention becomes very important in diabetic patients, although this can be even more difficult to achieve than in non-diabetic patients. This article compares the degree of control of CVRF and drugs prescribed to diabetics versus non-diabetics in the MIRVAS study. It also evaluates the results of an intensive and multifactorial intervention regarding both subjects in this population.


METHODS
The subgroups of diabetic patients are compared (71 patients: 38 in the intervention group and 33 in the control group) within groups and with the non-diabetics (176 patients: 83 and 93, respectively), all of them included in the MIRVAS study. The targets of CVRF control and drugs to be prescribed are those recommended in the international guidelines.


RESULTS
The baseline prevalence of high blood pressure and dyslipidemia is higher in diabetic patients (70.4% vs. 54% and 73.2% vs. 50.6%, respectively). At one year after the cardiovascular event, blood pressure (BP) and HDL-cholesterol control are significantly worse in diabetics (45.9% of diabetic patients vs. 81.9% of non-diabetics with BP under control; 49.43 mg/dl in diabetics vs 53.82 mg/dl in non-diabetics). Diabetics from the intervention group have better HbA1c (5.52% vs. 6.59%), HDL-cholesterol (52.81 mg/dl vs. 45.24 mg/dl), systolic BP (123.03 mmHg vs. 136.50 mmHg) and statins prescription (96.77% vs. 76.67%).


CONCLUSIONS
Diabetes mellitus makes it more difficult to achieve the objectives of control in secondary prevention. An intensive and multifactorial intervention such as that one done in MIRVAS study can attain better results.
de Pablo
C Ciria
CC
Area 6 de Atención Primaria, Madrid, España. cciria2002@yahoo.es
Palanco
M A Moreno
MA
Sanz
P Ibáñez
PI
Luis
C Sánchez
CS
Portillo
A Pizarro
AP
Fernández
C Suárez
CS
D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D018890:Chemoprevention; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors