title: Compliance with cardiovascular drug prevention measures in a general population: the Multidisciplinary Intervention in Primary Care (IMAP) study.
abstract: OBJECTIVE
  To evaluate adherence to guideline-recommended drug therapies for primary and secondary cardiovascular prevention in a general Mediterranean population.
  
  
  METHODS
  A cross-sectional study was conducted in a random sample of 2270 individuals (18-80 years) assigned to a health centre in Malaga (Spain). The appropriate use was analysed of statins, antithrombotics, beta-blockers, and angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II type 1 receptor blockers (ARB), based on the criteria of the European Guidelines on Cardiovascular Prevention and the European Society of Hypertension-European Society of Cardiology.
  
  
  RESULTS
  The prescription rate of statins, antithrombotics, beta-blockers, and ACEI/ARB was 7.8%, 5.1%, 3.3%, and 11%, respectively. The prescription of these drugs was inappropriate in 36.2%, 22.4%, 64.5%, and 0%, respectively. Overtreatment was more frequent in subjects with greater comorbidity or ≥ 2 vascular risk factors (p < 0.001). The percentage of individuals with prescription criteria but who did not receive the treatment was 19.5%, 4.7%, 2%, and 9.3%, respectively, increasing significantly with age, Charlson index, and the presence of ≥ 2 risk factors (p < 0.001). Only 11% of patients in secondary prevention received combination therapy with statins, antithrombotics, and ACEI/ARB. Patients with ischaemic heart disease, as compared to non-coronary vascular patients, more frequently received statins (56.1% vs. 25.6%; p = 0.0001) and antithrombotic drugs (66.7% vs. 56.4%; p = 0.02).
  
  
  CONCLUSIONS
  We detected a low adherence to existing pharmacological guidelines for the prevention of cardiovascular disease. A priority is to establish appropriate training and dissemination of cardiovascular prevention guidelines in the field of primary care.
authors.affiliation: Hospital Regional Universitario Carlos Haya, Malaga, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Lopez-Carmona
authors.forename: Mr
authors.initials: M
authors.lastname: Bernal-Lopez
authors.forename: J
authors.initials: J
authors.lastname: Mancera-Romero
authors.forename: S
authors.initials: S
authors.lastname: Jansen-Chaparro
authors.forename: I
authors.initials: I
authors.lastname: Portales-Fernandez
authors.forename: A J
authors.initials: AJ
authors.lastname: Baca-Osorio
authors.forename: R
authors.initials: R
authors.lastname: Perez-Gonzalez
authors.forename: F J
authors.initials: FJ
authors.lastname: Tinahones
authors.forename: R
authors.initials: R
authors.lastname: Gomez-Huelgas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011159:Population Surveillance; D011320:Primary Health Care / Q000379:methods*; D011322:Primary Prevention / Q000379:methods*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002317:Cardiovascular Agents