title: Comparison of Optimal Cardiovascular Risk Factor Management in Patients with Type 2 Diabetes Who Attended Urban Medical Health Center with those Attended a Tertiary Care Center: Experiences from Tehran, Iran.
abstract: BACKGROUND
  Diabetes is a leading cause of cardiovascular disease (CVD). Moreover, CVD accounts for primary cause of death among diabetic patients. Physicians, especially in the primary care setting, have effective role in the management of cardiovascular risk factors. Therefore, we aimed to compare the prevalence of modifiable cardiovascular risk factors in Type 2 diabetic patients attending to an urban health center as a primary care center with Institute of Endocrinology and Metabolism Diabetes Clinic (IEMDC) as a tertiary center.
  
  
  METHODS
  This cross-sectional study was performed on 200 adult diabetic patients attending urban health center (Abouzar Health Center) and 201 diabetic patients in a tertiary center. The patients' cardiovascular risk factors including lipid profile, systolic and diastolic blood pressure (BP), and smoking history were recorded. The number of patients who did not achieve the target according to the American Diabetes Association guidelines was determined and compared.
  
  
  RESULTS
  The patients in urban health center were older than those who attending IEMDC (P= 0.004). The duration of diabetes was longer among urban center patients (P< 0.001). Comparison of cardiovascular risk factors between two groups of patients showed a significant number of patients with poor-controlled low-density lipoprotein (75% vs. 44.7%) and triglyceride (74% vs. 51.7%) in patients attending primary center (P< 0.001). However, the prevalence of high diastolic BP (60.6% vs. 44.5%) was significantly higher in patients attending IEMDC (P= 0.001). There was no significant difference between the two centers' findings in glycosylated hemoglobin level, high-density lipoprotein level, and systolic BP.
  
  
  CONCLUSIONS
  Both centers have failure in target achievement in some risk factors; however, the inability of the primary care center in controlling hyperlipidemia in comparison with the tertiary center is a serious warning to provide training about managing dyslipidemia in these centers.
authors.affiliation: Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Sedighe
authors.initials: S
authors.lastname: Moradi
authors.affiliation: Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Javad
authors.initials: MJ
authors.lastname: Haji Ghanbari
authors.affiliation: Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hedyeh
authors.initials: H
authors.lastname: Ebrahimi
keywords: Cardiovascular risk factors; Type 2 diabetes; primary care setting; tertiary care setting