ORIGINAL RESEARCH Management of cardiovascular risk factors in people with diabetes in primary care: Cross-sectional study Alide Petri a, * , Simon de Lusignan b , John Williams c , Tom Chan d , Azeem Majeed a a Department of Primary Care and Social Medicine, Imperial College Faculty of Medicine, Charing Cross Campus, Reynolds Building, St Dunstan’s Road, London W6 8RP, UK b Primary Care Informatics, Department of Community Health Sciences, St George’s Hospital Medical School, London SW17 ORE, UK c Post Graduate Medical School, University of Surrey, Stirling House, Surrey Research Park, Guildford GU2 7DJ, UK d Surrey Hampshire Borders NHS Trust, Horizon Centre, Farnham Road Hospital, Guildford GU2 7LX, UK Received 31 January 2005; received in revised form 3 February 2006; accepted 6 March 2006 Available online 24 May 2006 KEYWORDS Diabetes mellitus; Cardiovascular risk factors; Primary health care; Sex inequalities Summary Objectives: Cardiovascular disease is the major cause of morbidity and mortality in people with diabetes. The management of cardiovascular risk factors in people with diabetes in primary care was compared with National Institute of Clinical Excellence guidelines. Design: A cross-sectional study in 26 general practices, with a combined list size of 256,188 patients, participating in the Kent, Surrey and Sussex Primary Care Research Network. Primary outcomes were process of care measures. Methods: Analysis of general practice computer data on the management of 5980 patients with diabetes, of whom 86% were aged 45 years and over. Results: The prevalence of diabetes was 2.0% in women and 2.6% in men, much lower than the estimated expected prevalence of 4.8% for women and 3.3% in men. Blood pressure was well recorded (96% in both sexes), cholesterol levels less well (79% of women, 84% of men). Hypertension (78% of women, 72% of men) was common. Twenty- one percent of women and 16% of men had a blood pressure above 160/100 mmHg, suggesting under use of antihypertensive therapy. Cholesterol levels were R5 mmol/l in 46% of women and 38% of men. Lipid-lowering drugs were prescribed in 38% of women and men. Aspirin was prescribed in 38% of women and 40% of men. Conclusions: There is an under-diagnosis of diabetes and an under-treatment of blood pressure and blood cholesterol, more marked in women than in men. There is Public Health (2006) 120, 654–663 0033-3506/$ - see front matter Q 2006 Published by Elsevier Ltd on behalf of The Royal Institute of Public Health. doi:10.1016/j.puhe.2006.03.010 * Corresponding author. Address: Greenwich Teaching Primary Care Trust, 31-37 Greenwich Park Street, Greenwich, London SE10 9LR, UK. Tel.: C44 20 8293 6778. E-mail address: lpetrri@compuserve.com (A. Petri).