doiSerbia

The effect of medicamentous and non-medicamentous therapy on lowering risk factors for cardiovascular and cerebrovascular episodes in an interventional study

Lapčević Mirjana (Dom zdravlja 'Voždovac', Beograd)
Vuković Mira (Zdravstveni centar, Valjevo)
Dimitrijević Ivan (Institut za psihijatriju, Klinički centar Srbije, Beograd)
Kalezić Nevena (Urgentni centar, Klinički centar Srbije, Beograd)
Ristić Jelena (Zdravstveni centar, Leskovac)

Introduction In a chain of cardiovascular episodes, risk factors (RF) and bad habits represent the first link. Objective The purpose of the study was to determine, during six months, on four examinations (the first, and three follow-ups after the second, fourth and sixth month), the following: physical activity (PA) alteration and the number of cigarettes smoked; the effect of antihypertensive betablockers and ACE inhibitors on systolic and diastolic arterial tension; the effect of metmorfin therapy on BMI, glycaemia, total cholesterol level (TCL) and triglycerides in diabetics compared to healthy individuals; the effect of hypolipidaemics on blood TCL and triglycerides in patients with angina pectoris (AP); the effect of betablocker therapy on TCL. Method This was a multicentric interventional study. Secondary prevention of coronary disease and cerebrovascular conditions was applied in the first half of 2005. There were 185 general practitioners from 38 health centers in Serbia, and patients of both sexes were included with the verified diagnosis of coronary disease and/or cerebrovascular condition. They had demographic data verified as well as data of being genetically (non)predisposed for AP, hypertension, myocardial infarction, stroke and diabetes mellitus. Descriptive and differential statistical methods were used for study result analysis. Results Out of 1,189 patients, there were 51.4% of women and 48.6% of men. The average age was 59.45±9.77 years. The population was homogeneous by sex and the factor of being genetically (non)predisposed for AP. There was a significant difference in examinations in four contacts in PA and cigarette smoking (p<0.0001). Systolic and diastolic pressure, TCL and triglycerides were significantly decreased by medicaments (p<0.05) and more significantly so associated with nonmedicamentous measures (p<0.001). Metmorfin significantly decreased the glycaemic level (p<0.001) both in diabetics and patients with a reduced tolerance level to glucose. In patients who took betablockers, there was lowering of TCL. Conclusion Taking medicaments significantly lowers RF, and more significantly so when associated with a non-medicamentous therapy.

Keywords: risk factors, cardiovascular episodes, cerebrovascular episodes, interventional study, medicamentous treatment, non-medicamentous therapy