Abstract: 570 TRANSLATING GUIDELINES INTO INTERVENTION

Abstract

Background: CVD remains the leading cause of global morbidity and mortality. Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, low consumption of fruit and vegetables, no alcohol intake and irregular physical exercise were associated with over 90% of AMI risk in Interheart. CVD Prevention Since CVD is multi-factorial, guidelines must guide identification of those at high risk, provide preventive and treatment goals, and remain simple to implement. Treating hypertension significantly lowers CVD; in 17 randomized trials of antihypertensive treatment, a reduction of 10-12 mmHg systolic BP and 5-6 mmHg diastolic BP reduced stroke incidence by 38% and CHD by 16%. Lowering LDL-C concentrations significantly reduces vascular events; a meta-analysis of 14 statin trials showed that every 40 mg/dL (1 mmol/L) decrease in LDL-C leads to a 21% decrease in CHD risk after 1 year. Barriers and incentives to CVD prevention Despite effective medication and guidance, studies show that at-risk patients often fail to reach the treatment goals recommended in guidelines. For example, in the US over 60% of people were not aware of their dyslipidemia, while among those aware 23% did not receive lipid-lowering therapy. There are governmental, physician and patient factors that can either detract from or improve implementation of guidelines.