Cardiovascular risk management: the success of target level achievement in high- and very high-risk patients in Hungary

Abstract

Abstract Background The management of risk factors in patients with high cardiovascular risk and its effectiveness is of paramount importance. Over the last decade, several studies have examined the achievement of cardiovascular risk factors' target levels in Europe. In the present Hungarian study, we assessed the cardiovascular risk level of participants in a population aged 40–65 years and the success of achieving risk factors' target levels in high- and very high-risk individuals. We compared these results with those of two similar European studies. Methods Our survey is a cross-sectional study involving a total of 37,778 patients aged 40–65 years from Hungary in 2019–2020. Cardiovascular risk levels and target values were set according to the 2016 European guideline. Target achievement was examined in terms of body mass index, waist circumference, blood pressure, total-, LDL-, HDL- cholesterol, triglyceride and (in diabetics) HgA1c levels. Results For 37,298 people, all the data were available to determine their cardiovascular risk category. Of these, 23.1% had a high and 31.4% a very high cardiovascular risk (men: 27.1% and 39.6%, women: 20.5% and 26.1%). Achievement of the LDL-C target of 1.8 mmol/l was only 8.0% among patients at very high risk, which is significantly below the European average (29%). Blood pressure target level attainment among high-risk patients was better than the European average (63.4% vs. 44.7%), but slightly lower (49.4% vs. 58%) among very high-risk patients. The proportion of people with type 2 diabetes achieving HgA1c below 7% was 57.3% in the high-risk population and 53% in the very high-risk population, in good agreement with the European average success rates (58.5% and 54% respectively). Waist circumference below 88 cm for women and 102 cm for men was achieved by 29.4% of the very high risk group in our survey, below the European average of 41%. Conclusions Our results show that the success rate of cardiovascular risk management in Hungary is below the European average in several parameters. Our data also highlight the low effectiveness of obesity management in Hungary. General practice partnerships may be important sites for positive change.