The COSEHC™ Global Vascular Risk Management quality improvement program: first follow-up report

Vasc Health Risk Manag. 2013:9:391-400. doi: 10.2147/VHRM.S44950. Epub 2013 Jul 22.

Abstract

The Global Vascular Risk Management (GVRM) Study is a 5-year prospective observational study of 87,863 patients (61% females) with hypertension and associated cardiovascular risk factors began January 1, 2010. Data are gathered electronically and cardiovascular risk is evaluated using the Consortium for Southeastern Hypertension Control™ (COSEHC™)-11 risk score. Here, we report the results obtained at the completion of 33 months since study initiation. De-identified electronic medical records of enrolled patients were used to compare clinical indicators, antihypertensive medication usage, and COSEHC™ risk scores across sex and diabetic status subgroups. The results from each subgroup, assessed at baseline and at regular follow-up periods, are reported since the project initiation. Inference testing was performed to look for statistically significant differences between goal attainments rates between sexes. At-goal rates for systolic blood pressure (SBP) were improved during the 33 months of the study, with females achieving higher goal rates when compared to males. On the other hand, at-goal control rates for total and low-density lipoprotein (LDL) cholesterol (chol) were better in males compared to females. Diabetic patients had lower at-goal rates for SBP and triglycerides but higher rates for LDL-chol. The LDL-chol at-goal rates were higher for males, while high-density lipoprotein (HDL)-chol rates were higher for females. Utilization of antihypertensive medications was similar during and after the baseline period for both men and women. Patients taking two or more antihypertensive medications had higher mean COSEHC™-11 scores compared to those on monotherapy. With treatment, hypertensive patients can reach SBP and cholesterol goals; however, population-wide improvement in treatment goal adherence continues to be a challenge for physicians. The COSEHC™ GVRM Study shows, however, that continuous monitoring and feedback to physicians of accurate longitudinal data is an effective tool in achieving better control rates of cardiovascular risk factors.

Keywords: cardiovascular risk; coronary heart disease; dyslipidemia; electronic medical records; hypertension; metabolic syndrome.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / therapeutic use*
  • Biomarkers / blood
  • Blood Pressure / drug effects*
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Chi-Square Distribution
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Diabetes Complications / etiology
  • Diabetes Complications / prevention & control
  • Drug Therapy, Combination
  • Dyslipidemias / blood
  • Dyslipidemias / complications
  • Dyslipidemias / drug therapy
  • Female
  • Guideline Adherence
  • Humans
  • Hypertension / complications
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Hypolipidemic Agents / therapeutic use
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Program Evaluation
  • Prospective Studies
  • Quality Improvement
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Treatment Outcome
  • Triglycerides / blood
  • United States

Substances

  • Antihypertensive Agents
  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Hypolipidemic Agents
  • Triglycerides