LOW EFFICACY OF THERAPY OF METABOLIC SYNDROM BETWEEN OUT-WARD PATIENTS IN GENERAL PRACTISE IN SLOVAKIA

Purpose. Presence of metabolic syndrome (MS) increases risk of cardiovascular (CV) events about 3.5 times. In Slovakia with stable yearly CV mortality more than 50%, may be control of components of MS of particular interest in general practise. Arterial hypertension (AH) and dyslipidemia are in focus of numerous trials, but their target values are seldom evaluated as components of  MS in out-ward pts
Methods: Crosssectional multicentric screening of MS and structure of medication was performed in  8699 consequetive out-ward pts in whole territory of Slovakia. MS was defined according to ATP III criteria.
Results. Out-ward pts aged 52.4±16.1 yrs [17-96 yrs] had 25.8% prevalence of  MS (M: 23.5%; F: 27.5%; p<0.001). AH (BP≥140/90 mmHg) or antihypertensive therapy  were present in 65.8% pts. Target blood pressure for MS [BP <130/85 mm Hg] was reached in 15.4% of MS+ pts and 21.5% of MS- of treated AH pts (0.01). Treated MS+ pts had significantly higher BP (141.8±18.04 vs 137.1±15.91 mm Hg (p<0.001) res. 84.7±9.02 vs 82.6±8.46 mm Hg (p<0.001).
MS+ pts were more often treated with hypolipidemics – 26.7% vs 17.0% (p<0.001), but therapy was less efficient: HDL cholesterol:  1.19±0.29 vs 1.53±0.41 mmol/l (p<0.001) and triglycerides (TG): 2.73±1.94 vs 1.64±1.00 mmol/l (p<0.001). MS+ pts less frequently reached target values for TG: 16.9 vs. 69.2% (p<0.001), despite of more frequent  use of fibrates (7.7% vs 3.1.%; p<0.05) and statins (19.7 vs 14.1%; p<0.05).  
MS+ pts were treated more expensively – antihypertensives cost 14.9 vs 13.1 SK of  DDD (p<0.001); hypolipodemics 12.3 vs 10.7 SK of DDD (p<0.001); and whole therapy was 34.7 vs 30.3 SK of DDD (p<0.01).
Conclusions: Screening of out-ward patients in general practise found 25.8% prevalence of  metabolic syndrom. Antihypertensive and hypolipidemic therapies were more expensive and less efficient in patients with metabolic syndrome.