IMPROVEMENT IN THE CONTROL OF RISK FACTORS ACHIEVED AFTER A SHORT INTERVENTION IN PATIENTS WITH HIGH OR VERY-HIGH CARDIOVASCULAR RISK. EN EL PUNTO DE MIRA STUDY

Objective: Lack of adherence and therapeutic inertia prevent the control of risk factors, especially in patients with high cardiovascular risk (CVR). We assessed the evolution of these factors after a short intervention in this type of patients throughout the follow-up of the OPM study. Design and method: Multicenter, prospective and interventional study, carried out under usual clinical practice in patients with high CVR, selected by random sampling from 68 primary care or hospital outpatient clinics and 20 dialysis centers throughout Spain. Patients who meet the conditions of high or very high CVR are included. Control criteria are considered for BP (<140/80mmHg in patients >65 years and <130/80 mmHg in patients <65 years), dyslipidemia (High CV risk LDLc <70 mg/dL and Very High CV risk <55 mg/dL) and diabetes (HbA1c <7% or <8% if 80 years or older). After the baseline visit, where data collection was made from three months prior, patients were follow-up to 4 months (final visit) with a mid-term evaluation. BP, anthropometric measures and laboratory test were collected in both. Treatments can be freely modified in case of loss of control. Results: 1287 patients (821 M, 466 F) were included. 970 (75.3%) had very high CV risk and 317 (24.6%) had a high CV risk. They were outpatients 786 (61%) and 501 (38.9%) had chronic kidney disease and were on renal replacement therapy. 1117 (86.7%) were hypertensive, 778 (60.4%) diabetic and 1102 (85.6%) dyslipidemic.618 (48%) were hypertensive, dyslipidemic and diabetic at the same time. The BP control goes to 58.1% from 39.7% (p<0.001), diabetes 66.9% from 59.2% (p < 0.01) and dyslipidemia 46.5% from 30.6% (p < 0.01). Control of hypertension, diabetes and dyslipidemia at the same time were from 5.2% to 13% (p < 0.001). And those who do not have their hypertension, diabetes or dyslipidemia under control were reduced from 10.2% to 4.8% (p< 0.001). Conclusions: There is a slight improvement in the control of risk factors among patients with high or very-high risk in Spain (only 13%) after a short intervention. More involvement are needed between patients and physicians to change it.