Cardiovascular risk management among 1806 low risk patients in a primary care setting. Clinical Quality Improvement Network (CQIN) Investigators.

BACKGROUND: The purpose of this study was to define cardiovascular risk and management in low risk ambulatory patients. METHODS: Case-control, cross-sectional audit of 1806 patients from eight primary care clinics from 1992 to 1994. The case study group comprised 902 patients who had lipid profiles completed within six months of the index audit, and the control group comprised 904 age-, sex- and temporally matched patients with no lipid measurements. RESULTS: The prevalence of cardiovascular risk factors and risk factor management strategies between the cases and control subjects revealed that all risk factors and risk reduction interventions were significantly higher (P < 0.02) among patients with a recent measurement of their serum lipid profile. Logistic regression revealed previous lipid-lowering therapy and history of diabetes or dyslipidemia to be preferentially related to likelihood of serum lipid measurements. CONCLUSIONS: The data suggest that primary care physicians are more aggressive in the investigation of low risk patients with higher prevalence of traditional cardiovascular risk factors, relative to clinically similar patients with lower risk profiles. This practice pattern, based on history-derived risk stratification, is compatible with propagated consensus guidelines on cardiovascular risk reduction and represents an appropriate utilization of health resources by physicians concerned with the prevention of cardiovascular disease.