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Cardiovascular preventive medication and achievement of treatment targets in patients with osteoarthritis: Results from the MUST-Heart study

Session Poster Session III - Friday 08:30 - 12:30

Speaker Silvia Rollefstad

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Cardiovascular Rehabilitation
  • Session type : Poster Session

Authors : S Rollefstad (Oslo,NO), E Ikdahl (Oslo,NO), N Oesteraas (Oslo,NO), TK Kvien (Oslo,NO), AG Semb (Oslo,NO)

Authors:
S Rollefstad1 , E Ikdahl1 , N Oesteraas2 , TK Kvien2 , AG Semb1 , 1Diakonhjemmet Hospital, Preventive Cardio-Rheuma Clinic, Department of Rheumatology - Oslo - Norway , 2Diakonhjemmet Hospital, Department of Rheumatology - Oslo - Norway ,

Citation:

Purpose: Undertreatment and poor goal attainment of blood pressure (BP) and lipids in both primary and secondary prevention has been reported in the general population. Our aim was to evaluate cardiovascular (CV) primary and secondary preventive treatment and attainment of recommended goals in patients with osteoarthritis (OA) in the Musculoskeletal pain in Ullensaker STudy (MUST).
Methods: The MUST is a population-based postal survey and a comprehensive clinical examination of persons with self-reported OA (n=630), of which 438 fulfilled the American College of Rheumatology criteria for OA. In the MUST-Heart study, usage of primary and secondary CV preventive medication as lipid lowering agents (LLA), anti-hypertensive medication (a-HT) and anti-thrombotic medication (AT) (acetylsalicylic acid and dipyridamole) was recorded. Guideline recommended BP goal is =140/90 mmHg, and low density lipoprotein cholesterol (LDL-c) goals for primary/secondary prevention are =2.5/=1.8 mmol/L, respectively. Attainment of BP and lipid targets for patients on the respective medications were evaluated.
Results: Secondary or primary CV prevention was indicated in 72 and 26 patients, respectively. The female/male ratios 45/27 and 5/21 and the median (IQR) age was 68.5 (65.0, 75.8) years and 66.5 (65.0, 73.8) years. Total Cholesterol (TChol) was: 5.17 (1.25) (SD) mmol/L/5.97 (1.19) mmol/L, high density lipoprotein cholesterol (HDL-c): 1.49 (0.46) mmol/L/1.22 (0.29) mmol/L, LDL-c: 2.97 (1.06) mmol/L/3.82 (1.06) mmol/L, BP was 140.5 (18.7)/82.4 (8.3) mmHg/155.7 (14.5) mmHg/87.2/10.1 mmHg, for the secondary/primary prevention groups. Of the 72 patients with diagnosed CV disease, 38 (52.8%) were using LLA, 47 (65.3%) a-HT medication and 25 (34.7%) were on AT medication. Of the 125 patients (without CV disease) who had hypertension, 57 (45.6%) used a-HT medication. Of the 26 patients with a calculated CV risk by SCORE =5%, 2 (7.7%) used LLA.Of the patient who were using a-HT medication, BP goal attainment was 20/47 (42.6%) and 0/57 (0%) for patients in the secondary and primary prevention groups. Of all patients using LLA, patients with CV disease achieved goals for TChol were 12/38 (31.6%) and LDL-c: 9/38 (23.7%).
Conclusions: There was a substantial underuse of cardio-protective drugs in persons with OA in the MUST-Heart study, which resulted in poor attainment of recommended BP and lipid targets. The goal achievement of BP and lipids in patients with OA was even lower than what is reported for the general population.

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