ARE RISK FACTORS TARGETS ACHIEVED AMONG PATIENTS WITH HIGH OR VERY HIGH CARDIOVASCULAR RISK IN SPAIN? PRELIMINARY RESULTS OF THE OBJETIVO EN EL PUNTO DE MIRA (OPM) STUDY

Objective: With the arrival of new and more powerful treatments, cardiovascular (CV) events are decreasing by better controlling risk factors. However, this situation seems to vanish in patients with high CV risk. Our purpose is to assess cardiovascular risk (CVR) control in a large sample of high-risk Spanish population, how many are outside the target according to international guidelines, and what factors are involved. 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, using the European stratification score and voluntarily agree to participate in the study are included. According to the European guidelines for CVR and the American Diabetes Association, control criteria are considered for BP (<140/80 mmHg 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). 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. 444 (39.7%) had hypertension, 457 (58.7%) diabetes and 337 (30.6%) dyslipidemia under control. Only 67 (5.2%) had hypertension, diabetes or dyslipidemia under control at the same time. And 132 (10.2%) had BP, glucose and lipid values above those recommended. Conclusions: Risk factor control among the Spanish population at high or very high CV risk is very poor. Only 5.2% of patients achieve the control goal according to international CV risk guidelines. So, for those 95% that are out of control, more efforts and improvement measures must be implemented in order to reduce their CV risk.