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Eur J Prev Cardiol. 2016 Jul;23(11):1202-10. doi: 10.1177/2047487316647827. Epub 2016 Apr 26.

Simplifying the audit of risk factor recording and control: A report from an international study in 11 countries.

Author information

1
Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands.
2
St Vincent's University Hospital, Dublin, Ireland.
3
Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
4
Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands Global Geo and Health Data Centre, Utrecht University, The Netherlands.
5
Department of Public Health, Ghent University, Belgium.
6
AZ Maria Middelares Hospital Ghent and Ghent University, Belgium.
7
University Hospital Centre Zagreb, School of Medicine, Zagreb University, Croatia.
8
Bispebjerg University Hospital, Copenhagen, Denmark.
9
Cardiology Department, Spedali Civili and University of Brescia, Italy.
10
Cardiovascular Prevention Centre, Health Unit 4 'Friuli Centrale', Udine, Italy.
11
King Saud University, Riyadh, Saudi Arabia.
12
Craigavon Cardiac Centre, Craigavon, UK.
13
University of Medicine and Pharmacy 'Victor Babes', Cardiology Department, Timisoara, Romania.
14
National Research Centre for Preventive Medicine, Moscow, Russia.
15
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan.
16
Beijing Anzhen Hospital, China.
17
Beijing Institute of Heart, Lung & Blood Vessel Diseases, Beijing Anzhen Hospital affiliated to the Capital University of Medical Sciences, Beijing, China.
18
Trinity College Dublin, Dublin Ireland ian@grahams.net.

Abstract

BACKGROUND:

To simplify the assessment of the recording and control of coronary heart disease risk factors in different countries and regions.

DESIGN:

The SUrvey of Risk Factors (SURF) is an international clinical audit.

METHODS:

Data on consecutive patients with established coronary heart disease from countries in Europe, Asia and the Middle East were collected on a one-page collection sheet or electronically during routine clinic visits. Information on demographics, diagnostic category, risk factors, physical and laboratory measurements, and medications were included and key variables summarized in a Cardiovascular Health Index Score.

RESULTS:

Coronary heart disease patients (N = 10,186; 29% women) were enrolled from 79 centres in 11 countries. Recording of risk factors varied considerably: smoking was recorded in over 98% of subjects, while about 20% lacked data on laboratory measurements relevant to cardiovascular disease risk. Sixteen per cent of participants reported smoking, 29% were obese, and 46% had abdominal obesity. Sixty per cent of participants had blood pressure <140/90 mmHg (140/80 mmHg for diabetics), 48% had HbA1c<7%, 30% had low-density lipoprotein <1.8 mmol/l and 17% had a good cardiovascular health index score. There were substantial regional variations. Less than 3% of patients attended cardiac rehabilitation in Asia or the Middle East, compared with 45% in Europe. In Asia, 15% of patients had low-density lipoprotein cholesterol <1.8 mmol/l compared with 33% in Europe and 36% in the Middle East. Variations in medications were noted, with lower use of statins in Asia.

CONCLUSIONS:

SURF proved to be practical in daily practice. Results indicated poor control of risk factors with substantial variation between countries, calling for development and implementation of clinical standards of secondary prevention of coronary heart disease.

KEYWORDS:

CHD; SURF; audit; management; recording; risk factors; secondary prevention

PMID:
27118362
DOI:
10.1177/2047487316647827
[Indexed for MEDLINE]

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