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The CAPITAL study (CArdiovascular Prevention wIth Telecardiology in ApuLia): preliminary results

Brunetti, Natale Daniele; Lanzone, Saverio; Dellegrottaglie, Giulia; Di Giuseppe, Giuseppe; De Gennaro, Luisa; Novielli, Vito; Straziota, Ernesto; Loiacono, Teresa; Di Biase, Matteo

Journal of Cardiovascular Medicine: July 2016 - Volume 17 - Issue 7 - p 455–461
doi: 10.2459/JCM.0000000000000286
CV prevention

Background The CArdiovascular Prevention wIth Telecardiology in ApuLia (CAPITAL) study aimed to investigate the prevalence of cardiovascular risk factors, the status of cardiovascular prevention, and the compliance to international scientific societies’ guidelines on cardiovascular prevention in a Mediterranean region.

Methods The CAPITAL study was based on the assessment of cardiovascular risk and compliance to guidelines on cardiovascular prevention, and on an electrocardiogram screening with remote telemedicine support performed in pharmacies of Apulia (Italy); the study was expected to enroll 10 000 consecutive patients accessing their usual pharmacy.

Results In the first 1000 patients enrolled, 16% were smokers, 9% diabetic, 26% hypertensive, 43% overweight, and 23% obese; 37% of the patients treated with antihypertensive drugs did not achieve the target levels, regardless of the number of antihypertensive drugs given, and 60% of subjects treated with lipid-lowering drugs did not achieve the target levels.

Twenty-two per cent of the patients subjected to the lipid-lowering drugs did not check their cholesterol levels in the past 12 months, and 21% of those taking antihypertensive drugs did not check their blood pressure levels.

Left ventricular hypertrophy was detected at electrocardiogram examination in 3.4% of the cases, and in 2.6% of the patients with unknown hypertension: 52% of the hypertensive patients were not checked with an electrocardiogram in the past 12 months, 44% of the diabetic patients, and 44% of subjects treated with lipid-lowering drugs.

Conclusions The awareness, therapy, and control of cardiovascular risk factors in a Mediterranean real-world population are unsatisfactory. There is a large scope of an improvement in the control of cardiovascular risk factors. Telemedicine support and pharmacy-based assessment may be helpful in implementing strategies aimed at the improvement of cardiovascular prevention.

aCardiology Department, University of Foggia, Foggia

bCardiology Departement, Ospedale Di Venere

cCardio-on-line Europe

dOspedale San Paolo

eFar.P.As, Bari, Italy

Correspondence to Natale Daniele Brunetti, MD, PhD, FESC, Assistant Professor, Cardiology Department, University of Foggia, Viale Pinto 1, 71100 Foggia, Italy Tel: +39 03389112358; fax: +39 0881745424; e-mail:

Received 17 November, 2014

Revised 28 January, 2015

Accepted 31 March, 2015

© 2016 Italian Federation of Cardiology. All rights reserved.