[Influence of morbidity, metabolic control, and use of resources in subjects with cardiovascular risk in the primary care setting].
OBJECTIVE
To determine the comorbidity, the therapeutic objectives, and economic impact in subjects with cardiovascular risk in primary care (PC).


METHODS
Multicentre, cross-sectional study.


METHODS
Five urban PC centres, Spain.


METHODS
Patients over 55 years seen during the year 2006. Compared according to the presence/absence of a cardiovascular event (CVE).


METHODS
Demographics, cardiovascular/general comorbidity (adjusted clinical groups), Charlson index, clinical parameters, multiple drugs and semi-fixed direct costs (operational) and variables (tests, referrals, drugs). A logistical regression and ANCOVA analysis was performed to correct the models. SPSSWIN Program (P< .05).


RESULTS
Of 24 410 patients, 15.4% (CI, 14.9-15.9) had a CVE. The subjects with a CVE showed a higher mortality (4.0% vs 1.8%) and general morbidity (8.1 vs 6.4 episodes) (P< .001). The CVE had an independent association in males (OR=2.7), Charlson index (OR=2.1), dyslipaemia (OR=1.5), depression (OR=1.4), age (OR=1.3), arterial hypertension (OR=1.2) and diabetes (OR=1.1) (P< .005). In primary prevention worse average cholesterols were obtained (211.6 vs 192.4 mg/dL), while in secondary prevention blood glucose was worse (111.3 vs 104.2 mg/dL; P< .001). The average corrected direct costs were euro1543.55 versus euro1027.65, respectively (P< .001). These differences were maintained in all the cost components.


CONCLUSIONS
The presence of a CVE is associated with higher comorbidity, causing an increase in costs. The achievement of therapeutic control objectives could be improved, in primary prevention as well as in secondary. Intervention strategies should be increased to modify life styles in these patients.
Sicras-Mainar
Antoni
A
Dirección de Planificación y Desarrollo Organizativo. Badalona Serveis Assistencials S.A. Badalona. Barcelona. España. asicras@bsa.gs
Velasco-Velasco
Soledad
S
González-Rojas Guix
Nuria
N
Clemente-Igeño
Chencho
C
Rodríguez-Cid
José Luis
JL
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control* / Q000628:therapy; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011322:Primary Prevention; D012307:Risk Factors; D055502:Secondary Prevention; D013030:Spain
D001786:Blood Glucose; D006442:Glycated Hemoglobin