The COSEHC™ Global Vascular Risk Management quality improvement program: first follow-up report

Abstract

The Global Vascular Risk Management (GVRM) Study is a 5-year prospective observational study of 87,863 patients (61% females) with hypertension and associated cardiovascular risk factors began January 1, 2010. Data are gathered electronically and cardiovascular risk is evaluated using the Consortium for Southeastern Hypertension Control™ (COSEHC™)-11 risk score. Here, we report the results obtained at the completion of 33 months since study initiation. De-identified electronic medical records of enrolled patients were used to compare clinical indicators, antihypertensive medication usage, and COSEHC™ risk scores across sex and diabetic status subgroups. The results from each subgroup, assessed at baseline and at regular follow-up periods, are reported since the project initiation. Inference testing was performed to look for statistically significant differences between goal attainments rates between sexes. At-goal rates for systolic blood pressure (SBP) were improved during the 33 months of the study, with females achieving higher goal rates when compared to males. On the other hand, at-goal control rates for total and low-density lipoprotein (LDL) cholesterol (chol) were better in males compared to females. Diabetic patients had lower at-goal rates for SBP and triglycerides but higher rates for LDL-chol. The LDL-chol at-goal rates were higher for males, while high-density lipoprotein (HDL)-chol rates were higher for females. Utilization of antihypertensive medications was similar during and after the baseline period for both men and women. Patients taking two or more antihypertensive medications had higher mean COSEHC™-11 scores compared to those on monotherapy. With treatment, hypertensive patients can reach SBP and cholesterol goals; however, population-wide improvement in treatment goal adherence continues to be a challenge for physicians. The COSEHC™ GVRM Study shows, however, that continuous monitoring and feedback to physicians of accurate longitudinal data is an effective tool in achieving better control rates of cardiovascular risk factors.

Hemodynamic and hormonal patterns of untreated essential hypertension in men and women

“…Although 70% of deaths in women are attributable to modifiable risk factors such as hypertension, the question of whether antihypertensive therapy should take into consideration potential differences in mechanisms between sexes has not been answered. Women have lower blood pressure control rates (Abuful et al, 2005), they are less likely to be appropriately treated (Ferrario et al, 2013; Joyner et al, 2012; Lloyd-Jones et al, 2005a; Lloyd-Jones et al, 2005b), and data suggest that treatment efficacies differ between the two sexes (Turnbull et al, 2007; Turnbull et al, 2008a; Turnbull et al, 2008b). In an investigation of the response rates to different drug regimens, Thoenes et al (Thoenes et al, 2010) found a higher use of thiazides and beta-blockers in women.…”

Ocena parametrów lipidowych u pacjentów z rozpoznanym zespołem metabolicznym w zależności od ryzyka sercowo-naczyniowego obliczonego według skali SCORE

“…Metabolic syndrome (MetS) comprises a constellation of CV risk factors that include abdominal obesity, insulin resistance, glucose intolerance, elevated blood pressure or antihypertensive drug treatment, low levels of high-density lipoprotein (HDL-C) cholesterol, and elevated triglyceride (TG) levels [6][7][8][9][10]. Abundant evidence shows that MetS predicts the development of CVD [11][12][13].…”