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Rationale for multiple risk intervention: the need to move from theory to practice.

Erhardt LR - Vasc Health Risk Manag (2007)

Bottom Line: These factors, such as low-density lipoprotein (LDL)-cholesterol, elevated blood pressure, obesity, and insulin resistance have a continuous, progressive impact on total CV risk, with higher levels and numbers of factors translating into greater risk.Effective and well-tolerated pharmacotherapies are available for the treatment of risk-factors.Patient compliance and persistence to available therapies is also necessary for successful modulation of CVD risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Sciences, Medicine, Lund University, Malmö University Hospital, Malmö, Sweden. leif.erhardt@med.lu.se

ABSTRACT
Incidence of cardiovascular (CV) and metabolic disease is increasing, in parallel with associated risk factors. These factors, such as low-density lipoprotein (LDL)-cholesterol, elevated blood pressure, obesity, and insulin resistance have a continuous, progressive impact on total CV risk, with higher levels and numbers of factors translating into greater risk. Evaluation of all known modifiable risk factors, to provide a detailed total CV disease (CVD) and metabolic risk-status profile is therefore necessary to ensure appropriate treatment of each factor within the context of a multifactorial, global approach to prevention of CVD and metabolic disease. Effective and well-tolerated pharmacotherapies are available for the treatment of risk-factors. Realization of the potential health and economic benefits of effective risk factor management requires improved risk factor screening, early and aggressive treatment, improved public health support (ie, education and guidelines), and appropriate therapeutic interventions based on current guidelines and accurate risk assessment. Patient compliance and persistence to available therapies is also necessary for successful modulation of CVD risk.

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Related in: MedlinePlus

Comparison of actual versus perceived 10-year risk among 80 Swedish general practitioners when asked to estimate the risk of specific patient profiles. Data drawn from Backlund L, Bring J, Strender L-E. 2004. How accurately do general practitioners and students estimate coronary risk in hypercholesterolaemic patients? Primary Health Care Research and Development, 5:145–52.
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fig4: Comparison of actual versus perceived 10-year risk among 80 Swedish general practitioners when asked to estimate the risk of specific patient profiles. Data drawn from Backlund L, Bring J, Strender L-E. 2004. How accurately do general practitioners and students estimate coronary risk in hypercholesterolaemic patients? Primary Health Care Research and Development, 5:145–52.

Mentions: Improved screening for CV risk factors and the metabolic syndrome is vital if long-term reductions in overall morbidity and mortality are to be achieved. Many CV risk factors (such as hypertension, hypercholesterolemia, or IGT) are ‘silent’ and individuals will not necessarily be aware that they are at an increased risk. Reducing overall CV risk therefore needs to begin by evaluating all known modifiable risk factors so that a detailed CV and metabolic risk-status profile can be created and appropriate management implemented. Secondly, while many individuals recognize that their behavior is associated with increased CV risk, there is often a lack of motivation to make lifestyle changes. Strategies such as motivational interviewing (Shinitzky and Kub 2001) and improving community opportunities for physical activity can be effective at helping patients to implement and maintain lifestyle changes. Thirdly, physicians need to recognize the importance of early and aggressive treatment and make appropriate therapeutic interventions based on current guidelines and accurate risk assessment. However, physicians’ assessments of CV risk may deviate significantly from scores measured using the risk charts, suggesting that initiatives are needed to promote accurate risk assessment techniques (Mosca et al 2005). Generally, primary care physicians seem to underestimate total CV risk (Figure 4), thus making the use of tools to assess the CV risk important in clinical practice (Backlund et al 2004).


Rationale for multiple risk intervention: the need to move from theory to practice.

Erhardt LR - Vasc Health Risk Manag (2007)

Comparison of actual versus perceived 10-year risk among 80 Swedish general practitioners when asked to estimate the risk of specific patient profiles. Data drawn from Backlund L, Bring J, Strender L-E. 2004. How accurately do general practitioners and students estimate coronary risk in hypercholesterolaemic patients? Primary Health Care Research and Development, 5:145–52.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2350141&req=5

fig4: Comparison of actual versus perceived 10-year risk among 80 Swedish general practitioners when asked to estimate the risk of specific patient profiles. Data drawn from Backlund L, Bring J, Strender L-E. 2004. How accurately do general practitioners and students estimate coronary risk in hypercholesterolaemic patients? Primary Health Care Research and Development, 5:145–52.
Mentions: Improved screening for CV risk factors and the metabolic syndrome is vital if long-term reductions in overall morbidity and mortality are to be achieved. Many CV risk factors (such as hypertension, hypercholesterolemia, or IGT) are ‘silent’ and individuals will not necessarily be aware that they are at an increased risk. Reducing overall CV risk therefore needs to begin by evaluating all known modifiable risk factors so that a detailed CV and metabolic risk-status profile can be created and appropriate management implemented. Secondly, while many individuals recognize that their behavior is associated with increased CV risk, there is often a lack of motivation to make lifestyle changes. Strategies such as motivational interviewing (Shinitzky and Kub 2001) and improving community opportunities for physical activity can be effective at helping patients to implement and maintain lifestyle changes. Thirdly, physicians need to recognize the importance of early and aggressive treatment and make appropriate therapeutic interventions based on current guidelines and accurate risk assessment. However, physicians’ assessments of CV risk may deviate significantly from scores measured using the risk charts, suggesting that initiatives are needed to promote accurate risk assessment techniques (Mosca et al 2005). Generally, primary care physicians seem to underestimate total CV risk (Figure 4), thus making the use of tools to assess the CV risk important in clinical practice (Backlund et al 2004).

Bottom Line: These factors, such as low-density lipoprotein (LDL)-cholesterol, elevated blood pressure, obesity, and insulin resistance have a continuous, progressive impact on total CV risk, with higher levels and numbers of factors translating into greater risk.Effective and well-tolerated pharmacotherapies are available for the treatment of risk-factors.Patient compliance and persistence to available therapies is also necessary for successful modulation of CVD risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Sciences, Medicine, Lund University, Malmö University Hospital, Malmö, Sweden. leif.erhardt@med.lu.se

ABSTRACT
Incidence of cardiovascular (CV) and metabolic disease is increasing, in parallel with associated risk factors. These factors, such as low-density lipoprotein (LDL)-cholesterol, elevated blood pressure, obesity, and insulin resistance have a continuous, progressive impact on total CV risk, with higher levels and numbers of factors translating into greater risk. Evaluation of all known modifiable risk factors, to provide a detailed total CV disease (CVD) and metabolic risk-status profile is therefore necessary to ensure appropriate treatment of each factor within the context of a multifactorial, global approach to prevention of CVD and metabolic disease. Effective and well-tolerated pharmacotherapies are available for the treatment of risk-factors. Realization of the potential health and economic benefits of effective risk factor management requires improved risk factor screening, early and aggressive treatment, improved public health support (ie, education and guidelines), and appropriate therapeutic interventions based on current guidelines and accurate risk assessment. Patient compliance and persistence to available therapies is also necessary for successful modulation of CVD risk.

Show MeSH
Related in: MedlinePlus