A retrospective cohort study published in Cureus on January 31, 2026, assessed the effectiveness of a specialized vascular risk clinic in Portugal in controlling major modifiable cardiovascular (CV) risk factors. Conducted between January 2022 and April 2023 (16 months), the analysis included 229 consecutive patients referred to the clinic, predominantly those with established atherosclerotic CV disease (ASCVD), diabetes, or high/very high CV risk per ESC/EAS guidelines. The multidisciplinary approach involved cardiologists, endocrinologists, nutritionists, and nurses, emphasizing intensive lifestyle counseling (diet, exercise, smoking cessation) alongside evidence-based pharmacotherapy titration (statins, antihypertensives, antiplatelet agents, GLP-1 agonists/SGLT2 inhibitors where indicated).
Baseline characteristics reflected a high-risk population: mean age approximately 65–70 years, high prevalence of hypertension (>80%), dyslipidemia (>90%), type 2 diabetes (~40–50%), current/former smoking (~30–40%), and obesity/overweight (majority BMI >25 kg/m²). At enrollment, control rates were suboptimal for several factors, consistent with real-world European data showing gaps in secondary prevention.
Follow-up assessments demonstrated statistically significant improvements across domains. Systolic/diastolic blood pressure decreased notably, with attainment of targets (<140/90 mmHg or stricter <130/80 mmHg in high-risk subgroups) rising substantially. LDL-cholesterol levels fell significantly, with a marked increase in patients achieving very high-risk targets (e.g., <55 mg/dL per ESC 2019 guidelines), driven by high-intensity statin use and ezetimibe/PCSK9 inhibitor addition when needed. Glycemic control (HbA1c) improved in diabetic patients, supported by newer glucose-lowering agents with CV benefit. Smoking prevalence declined through structured cessation programs, and mean BMI reduction reflected successful dietary/exercise interventions.
Overall, the clinic achieved better alignment with guideline recommendations compared to general practice settings, with higher proportions reaching composite risk factor goals. No major safety concerns were reported. The authors conclude that dedicated vascular risk clinics facilitate comprehensive, intensive management leading to superior risk factor optimization and potential long-term CV event reduction in high-risk Portuguese patients. Limitations include the retrospective single-center design, absence of a control group, relatively short follow-up, and possible selection bias toward motivated patients. These results support expanding specialized clinics to bridge gaps in CV prevention and secondary care in Portugal and similar healthcare systems.
