MAIN RESULTS OF SCREENING METHODOLOGY TO REVEAL CARDIO- AND CEREBROVASCULAR PATHOLOGY IN PRIMARY OUTPATIENT CARE

Abstract

Aim. To evaluate diagnostic significance of screening methodology for ischemic heart disease (CHD) and cerebrovascular disease (CD) and to adapt it to the outpatient and polyclinic conditions of primary medical care.

Material and methods. Totally 303 patients investigated, of those 143 were men of 40–70 years old and 160 were women at the age 55–70 without signs of cognitive impairment, having appointed at general practitioner office “for any reason”. The investogation was done according to standard procedure including unified questionnaire for CHD, various forms of CD, and resting ECG evaluated by Minnesota code. For diagnosis verification all patients were examined by neurologist and cardiologist, additional methods used if needed.

Results. The sensitivity of screening method for CHD reached 90,4%, specificity — 94,8%, for CD — 91,4% and 94,3%, respectively. In 19,8% of patients it was the first time to diagnose CD. Patients with arterial hypertension had various forms of CD in 55% cases. Also in 21% of participants chronic CD was diagnosed for the first time. Seventy six (25,1%) of hypertensives had cerbral crises in anamnesis, but this diagnosis appeared in outpatient charts only in 5,2% cases.

Conclusion. Screening is diagnostically significant for CHD and CD detecting. It made possible to find out chronic forms of CD in every fifth individual in the study for the first time. An insufficient knowledge of outpatient care practitioners is shown on symptoms of chronic CD and cerebral hypertensive crises in patients with arterial hypertension.