Copyright
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Risk factors in cardiovascular patients: Challenges and opportunities to improve secondary prevention
Rahima Gabulova, Anna Marzà-Florensa, Uzeyir Rahimov, Mahluga Isayeva, Shahana Alasgarli, Afag Musayeva, Sona Gahramanova, Firdovsi Ibrahimov, Farid Aliyev, Galib Imanov, Rahmana Rasulova, Ilonca Vaartjes, Kerstin Klipstein-Grobusch, Ian Graham, Diederick E Grobbee
Rahima Gabulova, Sona Gahramanova, Teaching-Therapeutical Hospital, Azerbaijan Medical University, Baku AZ1022, Azerbaijan
Anna Marzà-Florensa, Ilonca Vaartjes, Kerstin Klipstein-Grobusch, Diederick E Grobbee, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht 3508 GA, Netherlands
Uzeyir Rahimov, Department of Cardiology, Baku Medical Plaza, Baku AZ1014, Azerbaijan
Mahluga Isayeva, Department of CHD and Arrhythmias, Scientific-Research Institute of Cardiology, Baku AZ1072, Azerbaijan
Shahana Alasgarli, Firdovsi Ibrahimov, Department of Cardiology, Central Clinic Hospital, Baku AZ1006, Azerbaijan
Afag Musayeva, Farid Aliyev, Heart Center, Baku Health Center, Baku AZ1072, Azerbaijan
Galib Imanov, Teaching-Surgical Hospital, Azerbaijan Medical University, Baku AZ1022, Azerbaijan
Rahmana Rasulova, Department of Public Health, Azerbaijan Medical University, Baku AZ1022, Azerbaijan
Ian Graham, Department of Cardiology, Trinity College Dublin, Dublin Dublin-2, Ireland
Author contributions: Gabulova R analyzed the data and wrote the manuscript; Marzà-Florensa A was involved in all stages of developing the final version of the manuscript; Rahimov U, Isayeva M, Alasgarli S, Musayeva A, Gahramanova S, Ibrahimov F, Aliyev F, and Imanov G collected the clinical data and contributed equally to this work; Rasulova R analyzed the data; Vaartjes I and Klipstein-Grobusch K critically reviewed the manuscript; Graham I and Grobbee DE designed the research study and critically reviewed the work; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Research Ethic Committee of The National Cardiac Society of Azerbaijan (No. 01/2022).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: There is no conflict of interests to disclose. SURF II is conducted within the framework of the ESC Prevention of CVD Programme, led by the European Association of Preventive Cardiology (EAPC).
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Rahima Gabulova, MD, PhD, FESC, Associate Professor, Teaching-Therapeutical Hospital, Azerbaijan Medical University, 100 Mardanov Brothers, Baku AZ1022, Azerbaijan. rahima.gabulova@gmail.com
Received: March 25, 2023
Peer-review started: March 25, 2023
First decision: June 1, 2023
Revised: June 14, 2023
Accepted: July 3, 2023
Article in press: July 3, 2023
Published online: July 26, 2023
Processing time: 121 Days and 16.6 Hours
ARTICLE HIGHLIGHTS
Research background
Low level of monitoring and control of modifiable risk factors necessitates better structured effort and coordination of health care specialists from various healthcare facilities. The strategic needs for prevention and rehabilitation in Azerbaijan are to increase the number of rehabilitation centers and ensure their adequate geographical distribution, with a particular focus on the country's regions, and to expand indications of cardiac rehabilitation (CR) services and programs for primary and secondary prevention for the population with high and very high cardiovascular risk, and to expand indications of CR services and programs for primary and secondary prevention for the population with high and very high cardiovascular risk. It is also proposed that cardiac clinics adopt Standard Operating Procedures. More effort is required to improve and reinforce the process for primary health care provider education in the field of cardiac prevention and rehabilitation.
Research motivation
Previous studies have shown that control of major cardiovascular risk factors is generally inadequate in patients with established atherosclerotic cardiovascular disease (CVD) (ASCVD). Azerbaijan is a country in the South Caucasus, a region at very high risk for CVD. The aim of this study was to evaluate compliance with the recommendations of the European Society of Cardiology (ESC) for secondary prevention of CVD based on the measurement of both modifiable major risk factors and their therapeutic management in patients with confirmed coronary heart disease (CHD) in Azerbaijan. We believe that these results will contribute to the improvement of the situation in secondary prevention of CHD in the country.
Research objectives
This study focused on the national results of the Survey of Risk Factors in CHD (SURF CHD) II study in Azerbaijan.
Research methods
SURF CHD II study uses a one-page, standard questionnaire that allows rapid data collection. Information on demographics, risk factors, physical and laboratory data, and medications was collected in consecutive outpatients aged ≥ 18 years with established atherosclerotic CHD. Data from 687 patients (mean age 59.6 ± 9.58 years; 24.9% female) were included in the study.
Research results
The study results show that the control of cardiovascular risk factors and lifestyle modification measures indicated by clinical CVD prevention recommendations in patients with CHD are inadequate. The number of patients with CHD enrolled in a CR program is small as well.
Research conclusions
The findings of the SURF study can be used to improve processes by changing the techniques for documenting and monitoring CVD risk variables, and re-auditing can provide insight into the effectiveness of these modifications in improving the management of patients with ASCVD.
Research perspectives
It is critical to efficiently manage the main cardiovascular risk factors in order to prevent CVD mortality. The international SURF CHD II clinical audit measures modifiable risk factors to assess adherence to ESC recommendations for secondary prevention of CVD in patients with established CHD.
