Open Access Open Badges Research article

Implementation of Spanish adaptation of the European guidelines on cardiovascular disease prevention in primary care

Carlos Brotons1*, José Maria Lobos2, Miguel Ángel Royo-Bordonada3, Antonio Maiques4, Ana de Santiago5, Ángel Castellanos6, Santiago Diaz7, Juan Carlos Obaya8, Juan Pedro-Botet9, Irene Moral1, Vicenta Lizarbe10, Rosa Moreno11, Antonio Pérez12, Alberto Cordero13, Francisco Fornés-Ubeda14, Benilde Serrano-Saiz15, Miguel Camafort-Babkowski16, Roberto Elosua17, Susana Sans18, Carmen de Pablo19, Antonio Gil-Nuñez20, Fernando de Álvaro-Moreno21, Pedro Armario22, Olga Cortés Rico23, Fernando Villar24 and Ángel Lizcano25

Author affiliations

1 Research Unit, Sardenya Primary Health Care Center-Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain

2 Jazmín Primary Health Care Center, Health Regional Service (East Area), Madrid, Spain

3 National School of Public Health, Institute of Health Carlos III, Madrid, Spain

4 Manises Health Care Center, Valencia, Spain

5 Cogolludo Health Care Center, SESCAM, Guadalajara, Spain

6 Periodistas Primary Health Care Center, Health Regional Service (North Area), Madrid, Spain

7 Pintores Primary Health Care Center, Health Regional Service (South Area), Madrid, Spain

8 Chopera Primary Care Center, Health Regional Service (North Area), Madrid, Spain

9 Department of Medicine, Unidad Docente del IMAS, Hospital del Mar, Barcelona, Spain

10 Dirección General de Salud Pública, Calidad e Innovación, Ministerio de Sanidad, Servicios Sociales e Igualdad, Madrid, Spain

11 Angiología y Cirugía Vascular, Hospital Universitario de la Princesa, Madrid, Spain

12 Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

13 Department of Cardiology, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain

14 Salud Laboral de la Policía Local de Valencia, Valencia, Spain

15 Sociedad Española de Medicina y Seguridad del Trabajo, Sociedad Castellana de Medicina y Seguridad del Trabajo, Madrid, Spain

16 Servicio de Medicina Interna, ICMID. Hospital Clinic-IDIBAPS, Barcelona, Spain

17 Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain

18 Institut d’Estudis de la Salut, Barcelona, Spain

19 Unidad de Rehabilitación Cardiaca, Servicio Cardiología, Hospital Ramón y Cajal, Madrid, Spain

20 Unidad de Ictus, Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, Spain

21 Servicio de Nefrología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain

22 Unit of Hypertension and Vascular risk, Department of Internal Medicine, Hospital General de L’Hospitalet, University of Barcelona, Barcelona, Spain

23 Health Care Center Canillejas, Madrid, Spain

24 Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina Universidad Autónoma de Madrid, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

25 Universidad Rey Juan Carlos, Madrid, Spain

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Citation and License

BMC Family Practice 2013, 14:36  doi:10.1186/1471-2296-14-36

Published: 18 March 2013



The successful implementation of cardiovascular disease (CVD) prevention guidelines relies heavily on primary care physicians (PCPs) providing risk factor evaluation, intervention and patient education. The aim of this study was to ascertain the degree of awareness and implementation of the Spanish adaptation of the European guidelines on CVD prevention in clinical practice (CEIPC guidelines) among PCPs.


A cross-sectional survey of PCPs was conducted in Spain between January and June 2011. A random sample of 1,390 PCPs was obtained and stratified by region. Data were collected by means of a self-administered questionnaire.


More than half (58%) the physicians were aware of and knew the recommendations, and 62% of those claimed to use them in clinical practice, with general physicians (without any specialist accreditation) being less likely to so than family doctors. Most PCPs (60%) did not assess cardiovascular risk, with the limited time available in the surgery being cited as the greatest barrier by 81%. The main reason to be sceptical about recommendations, reported by 71% of physicians, was that there are too many guidelines. Almost half the doctors cited the lack of training and skills as the greatest barrier to the implementation of lifestyle and behavioural change recommendations.


Most PCPs were aware of the Spanish adaptation of the European guidelines on CVD prevention (CEIPC guidelines) and knew their content. However, only one third of PCPs used the guidelines in clinical practice and less than half CVD risk assessment tools.

Cardiovascular disease; Practice guidelines; Risk assessment; Primary care providers; Implementation