[Efficiency of primary prevention for diseases caused by atherosclerosis in patients at high cardiovascular risk in Russia and other European countries (Part 2)].

Background. The picture of primary prevention obtained from real-life practice makes possible scheduling measures for prevention improvement. Aim. To analyze features of drug and non-drug therapy aimed at decreasing cardiovascular risk in Russian patients with a high risk (HR) of CVD compared with the study general population. Materials and methods. 14 European countries, including the Russian Federation, participated in this cross-sectional study. The study included patients aged 18-80 without clinical signs of atherosclerosis who have received antihypertensive and/or lipid-lowering therapy and/or therapy for diabetes mellitus (DM) within >6 to <3 years of enrollment in the study. The study protocol included analysis of medical records and an interview focusing on a specially developed, structured questionnaire on major aspects of the life style (smoking, nutrition, physical activity, psychosocial factors), recommendations on drug and non-drug treatment, and patients' compliance. During the interview, anthropometrics, blood pressure (BP) and CO concentrations were recorded and venous blood was withdrawn for measuring levels of lipids, glucose, and HbA(1c). Oral glucose tolerance test was performed for all patients without fasting hyperglycemia of >= 11.1 mmol/l. Results. In total, 505 patients with HR were evaluated at Russian study sites and 405 interviews (71.6% females) were taken. Both in the Russian cohort and other countries, the most common recommendations for correction of overweight and obesity concerned diet and physical activity; a drug therapy was administered extremely rarely. Proportion of targeted exercise was approximately similar in the Russian cohort and the study as a whole, 16-18%. Antihypertensive medications were administered to 92.1% of patients in the Russian cohort and 82.7% of patients in the entire study. The most popular classes of antihypertensive drugs were beta-blockers (39.9% and 36.8% respectively), ACEI/ARB (79.6% and 79.8%), calcium antagonists (14.7% and 29.1%), and diuretics (26% and 38.3%). 18% and 35.6% of patients, respectively, received lipid-lowering drugs, and these drugs were statins in 89% and 96.1% of cases. Antihyperglycemic therapy was represented by oral drugs in 70.8% and 75.1% respectively; 16.7% and 18.3% of patients received insulin. Generally, patients estimated their compliance with the drug therapy rather highly. Conclusion. Results of the primary care arm of the EUROASPIRE IV survey indicate considerable room for improvement of CVD prevention.