Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Slovenian Journal of Public Health

The Journal of National Institute of Public Health

4 Issues per year


IMPACT FACTOR 2016: 0.429

CiteScore 2016: 0.26

SCImago Journal Rank (SJR) 2016: 0.177
Source Normalized Impact per Paper (SNIP) 2016: 0.222

Open Access
Online
ISSN
1854-2476
See all formats and pricing
More options …
Volume 50, Issue 1 (Jan 2011)

Unsatisfactory cardiovascular risk control - opportunities for family medicine

Mirjana Rumboldt
  • School of Medicine, Department of Family Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
/ Marion Kuzmanić
  • School of Medicine, Department of Family Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
/ Dragomir Petrić
  • School of Medicine, Department of Family Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
/ Zvonko Rumboldt
  • School of Medicine, Department of Family Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
Published Online: 2011-01-17 | DOI: https://doi.org/10.2478/v10152-010-0030-9

Unsatisfactory cardiovascular risk control - opportunities for family medicine

Although theoretically very effective and apparently quite straightforward, cardiovascular prevention leaves much to be desired in practice. Several reasons, including ethical, conceptual, psychological, and operative pitfalls (lifestyle changes are mostly ignored; drug therapy is too often prescribed with no good reason, and performed in an episodic or on/off way) are presented in this essay. Discussed are the grounds of these aberrations and suggested are some intuitive solutions, best achievable in family practice.

Nezadostno Obvladovanje Dejavnikov Tveganja za Srčno- Žilne Bolezni - Priložnost za Družinsko Medicino

Preprečevanje srčno-žilnih bolezni je teoretično zelo učinkovito in na videz precej enostavno, vendar pa je treba v praksi na tem področju še marsikaj storiti. Prispevek opisuje razloge takšnega stanja, tj. etične, konceptualne in psihološke dejavnike ter težave pri izvajanju. Zdravljenje z zdravili prevečkrat predpišemo brez pravega razloga, poteka pa občasno in neredno. Prispevek obravnava vzroke teh slabosti in predlaga nekaj rešitev, ki jih najlaže ponudi družinska medicina.

Keywords: cardiovascular diseases; prevention; family medicine

Keywords: srčno-žilne bolezni; preprečevanje; družinska medicina

  • Ford ES, Capewell S. Coronary heart disease mortality among young adults in the U. S. from 1980 through 2002: concealed leveling of mortality rates. J Am Coll Cardiol 2007; 50: 2128-32.Google Scholar

  • Greenland P, Lloyd-Jones D. Time to end mixed -and often incorrect- messages about prevention and treatment of atherosclerotic cardiovascular disease. JACC 2007; 50: 2133-5.Google Scholar

  • Erceg M, editor. Cardiovascular diseases in Croatia. Zagreb: HZJZ, 2004.Google Scholar

  • Kotseva K, Wood D, De Backer G, De Bacquer D, Pyörälä K, Keil U. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet 2009; 373: 929-40.Web of ScienceGoogle Scholar

  • Anon. Risk perception. Wikidepia. Accessed 1.6.2010 from: http://en.wikipedia.org

  • Rumboldt Z, Jurišić M, Bagatin J, Kuzmanić A, Mirić D, Obad M. Analysis of an operative research in Split: how to promote the treatment of arterial hypertension? Liječ Vjesn 1986; 108: 117-22.Google Scholar

  • Štifanić M, Dobi-Babić R. The patient's rights: who is going to live, and who to die? (in Croatian). Rijeka: Adamić, 2000: 63-70.Google Scholar

  • Jonsen AJ. A short history of medical ethics. New York, Oxford: University Press, 2000: 95-7.Google Scholar

  • Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 363: 937-52.Google Scholar

  • Vasan RS, Sullivan LM, Wilson PW, Sempos CT, Sundström J, Kannel WB, Levy L, D'Agostino RB. Relative importance of borderline and elevated levels of coronary heart disease risk factors. Ann Intern Med 2005; 142: 393-402.Google Scholar

  • Turek S, Rudan I, Smolej-Naračić N, Szirovicza L, Čubrilo-Turek M, Žerjavić-Hrabak V. A large cross-sectional study of health attitudes, knowledge, behaviour and risks in the post-war Croatian population (the First Croatian Health Project). Coll Antropol 2001; 25: 77-96.Google Scholar

  • Bergovec M, Reiner Ž, Miličić D, Vražić H. Differences in risk factors for coronary heart disease in patients from continental and Mediterranean regions of Croatia. Wien Klin Wschr 2008; 120: 684-92.Google Scholar

  • Stamler J, Stamler R, Neaton JD; Wentworth D, Daviglus ML, Garside D. Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women. JAMA 1999; 282: 2012-8.Google Scholar

  • Rumboldt M, Rumboldt Z, Pesenti S. Premature parental heart attack is heralding elevated risk in their offspring. Coll Antropol 2003; 27: 221-8.Google Scholar

  • Wong ND, Black HR, Gardin JM. Preventive cardiology. 2nd ed. New York: McGraw-Hill, 2005.Google Scholar

  • Glavaš D, Rumboldt M, Rumboldt Z. Smoking cessation with nicotine replacement therapy among health workers: randomized, double-blind study. Croat Med J 2003; 44: 219-24.Google Scholar

  • Serour M, Alqhenaei H, Al-Saqabi S, Mustafa AR, Ben-Nakhi A. Cultural factors and patients' adherence to lifestyle measures. Br J Gen Pract 2007; 57: 291-5.Google Scholar

  • Kuzmanić M, Vrdoljak D, Rumboldt M, Petric D. Metabolic syndrome in type 2 diabetics. Med Jad 2008; 38: 13-22.Google Scholar

  • Rumboldt Z, Rumboldt M. Pharmacoeconomics of the statin drugs. Period Biol 2002; 104: 107-12.Google Scholar

  • Pletcher MJ, Lazar L, Bibbins-Domingo K, Moran A, Rodondi N, Coxson P. Comparing impact and cost-effectiveness of primary prevention strategies for lipid lowering. Ann Intern Med 2009; 150: 243-54.Google Scholar

  • de Ferranti S, Ludwig DS. Storm over statins - the controversy surrounding pharmacologic treatment of children. N Engl J Med 2008; 359: 1309-12.Web of ScienceGoogle Scholar

  • The Cardiac Arrhythmia Suppression Trial (CAST) investigators. Primary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 1989; 321: 406-12.Google Scholar

  • Briel M, Ferreira-Gonzalez I, You JJ, Karanicolas PJ, Akl EA, Wu P. Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: systematic review and meta-regression analysis. BMJ 2009; 338: (doi: 10.1136/bmj.b92).PubMedCrossrefGoogle Scholar

  • Rumboldt Z, Božić I, Sardelić S. Secondary prevention of myocardial infarction: impact of clinical trials on clinical practice. Eur J Clin Pharmacol 1995; 48: 311-2.Google Scholar

  • Soumerai SB, McLaughlin TJ, Spiegelman D, Hertzmark E, Thibault G, Goldman L. Adverse outcomes of underuse of β-blockers in elderly survivors of acute myocardial infarction. JAMA 1997; 277: 115-21.Google Scholar

  • Rumboldt Z. The role of ω-3 fatty acids in cardiovascular prevention. Liječ Vjesn 2009; 131: 103-4.Google Scholar

  • Katić M, Jureša V, Orešković S. Family medicine in Croatia: past, present, and forthcoming challenges. Croat Med J 2004; 45: 543-9.Google Scholar

  • Gmajnić R, Pribić S, Lukić A, Ebling B, Ćupić N, Marković I. Effect of surgical training course on performance of minor surgical procedures in family medicine physician's offices: an observational study. Croat Med J 2008; 49: 358-63.Web of ScienceGoogle Scholar

  • Švab I. The challenged values of family medicine. Eur J Gen Pract 2009; 27: 1-2.Google Scholar

About the article


Published Online: 2011-01-17

Published in Print: 2011-01-01


Citation Information: Slovenian Journal of Public Health, ISSN (Online) 1854-2476, ISSN (Print) 0351-0026, DOI: https://doi.org/10.2478/v10152-010-0030-9.

Export Citation

This content is open access.

Comments (0)

Please log in or register to comment.
Log in