Improved cardiovascular risk profile in patients referred to a specialised vascular outpatient clinic: a cohort study.
We carried out a prospective cohort study in patients referred to our vascular outpatient clinic to see how their cardiovascular risk profile developed. The classical risk factors were compared at first visit and one year later. The adapted Framingham Heart Risk Score (FHRS) and the Heart SCORE (HS) were used to compare the cardiovascular risks. There was a decline of 9 and 5 mmHg in mean systolic blood pressure in the hypertension group and in the group with atherosclerotic disease, respectively. On average 0.6 and 0.8 antihypertensive agents were added. In the hypertension group mean LDL-level decreased from 3.2 to 2.4 mmol/l. For the secondary prevention group mean LDL-cholesterol decreased from 3.3 to 2.1 mmol/l. In the hypertension group, the 10-year relative risk of myocardial infarction (FHRS) decreased by 28% (95% CI 25-30). The 10-year relative risk on a fatal cardiovascular event (HS) decreased by 33% (95% CI 31-36). The absolute risk decreased by 3.3% (95% CI 2.0-4.6) and 1.4% (95% CI 0.5-2.3) by using the HS. We conclude that the cardiovascular risk profile of our patients significantly improved as shown by the FHRS or the HS. These benefits were reached by a decreasing number of smokers, better blood pressure control and a lower LDL-cholesterol.
Verdouw-van Tol
H C L
HC
Department of Internal Medicine, Groene Hart Ziekenhuis, Bleulandweg 10, 2803 HH, Gouda, The Netherlands.
Peltenburg
H G
HG
Koster
T
T
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology / Q000517:prevention & control; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D050197:Atherosclerosis / Q000453:epidemiology / Q000517:prevention & control; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D050171:Dyslipidemias / Q000453:epidemiology / Q000517:prevention & control; D005192:Family Health; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention; D055815:Young Adult
D008078:Cholesterol, LDL