Total cardiovascular risk: what do the doctors know?

Aim. To evaluate the knowledge of medical practitioners on total cardiovascular (CVD) risk assessment and ambulatory use of the SCORE instrument. Material and methods. In total, 229 medical practitioners from Russia and CIS countries participated in the anonymous survey: 72 % cardiologists and 26 % therapeutists. Mean age of the respondents was 44,6±11,7 years, with mean duration of working at the current position being 8,9±11,5 years. The survey questionnaire focused on the practical use of the SCORE risk assessment scale. Results. Ninety percent of the responders confirmed using the SCORE scale, 8,3 % were not using it, and 1,7 % did not know about the SCORE instrument. Among the SCORE components, 84 % of the practitioners correctly reported gender, age, blood pressure and total cholesterol; 75 % also correctly reported smoking; 40 % wrongly reported glucose and CVD in family history, while 30 % wrongly mentioned overweight, obesity, and waist circumference. Other risk factors (RFs) were wrongly reported by 6,6 % of the doctors (including education, reported by 3,3 %). Patients with diabetes mellitus and microalbuminuria, with three or more RF, or with total CVD risk >5 % were classified as having high total CVD risk by 80 % of the responders. Patients with confirmed CVD diagnosis were regarded as having high CVD risk by 67 % of the practitioners. Symptom-free patients with a very high level of a single RF were classified as having high CVD risk by 20 % of the responders only. Total CVD risk reduction, as a main goal of arterial hypertension treatment, was reported by 62 % of cardiologists and 58 % of therapeutists. Up to 54 % of the responders had RFs themselves. The interest in educational programmes for doctors, focusing on SCORE use in clinical practice, was very high (90 %). Conclusion. The study demonstrated inadequate knowledge of the practitioners on the methodology of total CVD risk assessment, an important instrument of primary prevention. The doctors attending medical educational programmes showed better levels of knowledge.

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