Huisarts en Wetenschap

, Volume 50, Issue 9, pp 655–660 | Cite as

Opsporing en registratie van de vier conventionele risicofactoren voor hart en vaatziekten in de dagelijkse praktijk

  • JT van Wyk
  • MAM van Wijk
  • MCJM Sturkenboom
  • PW Moorman
  • J van der Lei
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Samenvatting

Van Wyk JT, Van Wijk MAM, Sturkenboom MCJM, Moorman PW, Van der Lei J. Opsporing en registratie van de vier ‘conventionele’ risicofactoren voor hart en vaatziekten in de dagelijkse praktijk. Huisarts Wet 2007;50(9):421-5.

Achtergrond De vier conventionele risicofactoren voor hart- en vaatziekten (HVZ) zijn roken, hypertensie, diabetes mellitus en hypercholesterolemie. Het opsporen en behandelen van deze vier risicofactoren is een essentieel onderdeel van de preventie van HVZ.

Doel Wij wilden nagaan hoe huisartsen in de praktijk handelen als het gaat om de primaire en secundaire preventie van HVZ.

Methode Op basis van gegevens uit het IPCI-huisartsenregistratienetwerk keken wij in hoeverre de huisartsen vooraf de vier risicofactoren en de bijbehorende metingen hadden vastgelegd voor patiënten bij wie in de onderzoeksperiode voor het eerst de diagnose HVZ gesteld werd. Wij onderzochten de gegevens van alle in de registratie opgenomen patiënten van 18 jaar en ouder over de periode van september 1999 tot augustus 2003.

Resultaten Van de in de IPCI-registratie opgenomen patiënten voldeden er 157.216 aan onze inclusiecriteria. Bij 2597 van hen werd in de onderzoeksperiode een HVZ gediagnosticeerd. Bij 76% van de vrouwen en 73% van de mannen om wie het ging, had de huisarts ten minste één van de vier risicofactoren vastgelegd. In 40% van de gevallen had de huisarts voorafgaand aan de diagnose geen risicofactor vastgelegd en in 16% van de gevallen had hij voorafgaand aan de diagnose geen aan de risicofactoren gerelateerde metingen vastgelegd.

Conclusie Huisartsen lijken zich in de dagelijkse praktijk vooral te richten op secundaire preventie van HVZ. De primaire preventie van HVZ zal erbij gebaat zijn als huisartsen in de dagelijkse praktijk bewuster de risicoprofielen in kaart brengen van patiënten die eventueel in aanmerking komen voor preventieve interventies.

hart- en vaatziekten onderzoek registratie risicofactor 

Samenvatting

Van Wyk JT, Van Wijk MAM, Sturkenboom MCJM, Moorman PW, Van der Lei J. Identification and registration of the four ‘conventional’ cardiovascular disease risk factors in general practice. Huisarts Wet 2007;50(9):421-5.

Background Detecting and managing the four major conventional risk factors – smoking, hypertension, diabetes mellitus, and hypercholesterolemia – is pivotal in the primary and secondary prevention of cardiovascular disease (CVD).

Objective To assess the preventive activities of GPs regarding the four conventional risk factors and the associated measurements for cardiovascular risk factors by GPs in relation to the time of the first clinical presence of CVD.

Setting Large longitudinal general practice research database (the Integrated Primary Care Information database) in the Netherlands from September 1999 to August 2003.

Participants and methods Patients over 18 years of age with newly diagnosed CVD with a valid history of at least 1 year before and after the first clinical diagnosis of CVD. Details on conventional risk factors and associated measurements for the four cardiovascular risk factors were assessed in relation to the first clinical diagnosis of CVD.

Results In total, 157,716 patients met the study inclusion criteria. Of the 2,594 patients with newly diagnosed CVD, at least one of the four investigated risk factors was observed in 76% of women and 73% of men. In 40% of cases, no risk factor was recorded before the date of the first CVD diagnosis. In 16% of cases, no associated measurements were present before the first CVD diagnosis.

Conclusion In daily practice, GPs seem to focus on the secondary prevention of CVD. Intervention strategies that aim to influence GPs' case finding behaviour should focus on increasing the awareness of physicians in performing risk-factor-associated measurements in patients who are eligible for the primary prevention of CVD. Further research will have to show the feasibility and effectiveness of such intervention strategies.

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Copyright information

© Bohn Stafleu van Loghum 2007

Authors and Affiliations

  • JT van Wyk
    • 1
  • MAM van Wijk
  • MCJM Sturkenboom
  • PW Moorman
  • J van der Lei
  1. 1.

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