Evaluating the adequacy of cardiovascular risk factor control after myocardial revascularization surgery

Abstract

Background: Cardiovascular risk factors (RF) for coronary artery disease (CAD) are responsible for the occurrence of cardiovascular events. Objective: To estimate the percentage of patients submitted to myocardial revascularization surgery (MRS) that attains adequate control of modifiable RF at least six months after the surgery. Methods: Data collection was based on the review of medical records and a clinical interview of 88 patients submitted to MRS between January and December of 2004 at a reference hospital for cardiovascular diseases. The patients were interviewed in the follow-up period, between six and twelve months after the surgical revascularization. Results: Mean age was 63.1 ± 9.9 years; 51 patients (58%) were males, 86 (97.7%) were hypertensive, 38 (43.2%) were diabetic, 85 (96.6%) had hypercholesterolemia and 10 (11.4%) were smokers. Hypertension control (PA < 140 x 90 mmHg) was attained by 24.4% of the patients; cholesterol (LDL cholesterol < 100 mg/dl) and diabetes control (blood glucose levels < 110 mg/dl) levels were 30.6% and 31.6%, respectively. The use of antihypertensive drugs, hypoglycemic agents and statins, when indicated, were 96.5%, 92.1% and 78.8%, respectively. However, only 14.8% patients had their blood pressure, glucose and cholesterol levels within the limits accepted as adequate control. Conclusions: Despite the frequent use of drugs to control hypertension, diabetes and hypercholesterolemia, a high proportion of patients still do not achieve the target levels of risk factor control recommended by current guidelines at least six months after revascularization surgery, which suggests there is a great potential for improvement in clinical practice.