title: Evidence-based therapy prescription in high-cardiovascular risk patients: the REACT study.
abstract: BACKGROUND
  Data on outpatient care provided to patients at high cardiovascular risk in Brazil are insufficient.
  
  
  OBJECTIVE
  To describe the profile and document the clinical practice of outpatient care in patients at high cardiovascular risk in Brazil, regarding the prescription of evidence-based therapies.
  
  
  METHODS
  Prospective registry that documented the ambulatory clinical practice in individuals at high cardiovascular risk, which was defined as the presence of the following factors: coronary artery disease, cerebrovascular and peripheral vascular diseases, diabetes, or those with at least three of the following factors: hypertension, smoking, dyslipidemia, age > 70 years, family history of coronary artery disease, chronic kidney disease or asymptomatic carotid artery disease. Basal characteristics were assessed and the rate of prescription of pharmacological and non-pharmacological interventions was analyzed.
  
  
  RESULTS
  A total of 2364 consecutive patients were included, of which 52.2% were males, with a mean age of 66.0 years (± 10.1). Of these, 78.3% used antiplatelet agents, 77.0% used statins and of patients with a history of myocardial infarction, 58.0% received beta-blockers. Concomitant use of these three classes of drugs was 34%; 50.9% of hypertensive, 67% of diabetic and 25.7% of dyslipidemic patients did not achieve the goals recommended by guidelines. The main predictors of prescription therapies with proven benefit were centers with a cardiologist and history of coronary artery disease.
  
  
  CONCLUSIONS
  This national and representative registry identified important gaps in the incorporation of therapies with proven benefit, offering a realistic outlook of patients at high cardiovascular risk.
authors.affiliation: Hospital do Coração, São Paulo, SP.
authors.forename: Otávio
authors.initials: O
authors.lastname: Berwanger
authors.forename: Luiz Alberto
authors.initials: LA
authors.lastname: Piva e Mattos
authors.forename: José Fernando Vilela
authors.initials: JF
authors.lastname: Martin
authors.forename: Renato Delascio
authors.initials: RD
authors.lastname: Lopes
authors.forename: Estevão Lanna
authors.initials: EL
authors.lastname: Figueiredo
authors.forename: Daniel
authors.initials: D
authors.lastname: Magnoni
authors.forename: Dalton Bertolim
authors.initials: DB
authors.lastname: Precoma
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Machado
authors.forename: Jorge Ilha
authors.initials: JI
authors.lastname: Guimarães
authors.forename: Jadelson Pinheiro de
authors.initials: JP
authors.lastname: Andrade
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000592:standards*; D001938:Brazil; D002317:Cardiovascular Agents / Q000145:classification / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000628:therapy*; D004812:Epidemiologic Methods; D019317:Evidence-Based Medicine / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D017410:Practice Guidelines as Topic / Q000592:standards*; D012307:Risk Factors
chemical_list: D002317:Cardiovascular Agents