Key result
Cardiovascular guideline adherence in general practice varies widely, falling as low as ~4%.
Why the study?
Application of CVD-related clinical practice guidelines in primary care is often inconsistent, raising concerns about potential unconsidered barriers to implementation.
Systematic Review (n=37)
Adherence to cardiovascular guidelines in primary care is highly variable, highlighting the need for guidelines that emphasize practicality and account for multimorbid patients.
Variable adherence in primary care signals urgent implementation gaps for clinicians; extends evidence on barriers to guide targeted research.
BACKGROUND: Worldwide, cardiovascular diseases (CVDs) persist as a leading cause of mortality. Clinical practice guidelines (CPGs) aim to support evidence-based decision-making and improve outcomes in primary care. However, application of these guidelines is often inconsistent, raising concerns about potential unconsidered barriers to implementation. OBJECTIVES: This review aimed to assess the extent to which CVD-related CPGs are followed in general practice and factors influencing the application. METHODS: A structured literature review was conducted in August 2025 in accordance with the PRISMA-ScR guidelines, using MEDLINE (PubMed), Cochrane Library, and Web of Science. The inclusion criteria comprised original studies in English or German that focused on CPG adherence in primary care related to CVDs. RESULTS: After screening 791 studies, 37 were included. Most of these studies had a cross-sectional design and were conducted in Europe. Reported CPG application varied considerably, ranging from 4% to 100% depending on the disease area and evaluation method. Factors influencing CPG application included time constraints, systemic factors, and limitations within the guidelines themselves. Especially complex cases led to concerns about side effects and to deviations from the guideline. CONCLUSION: Despite high awareness, the adherence to cardiovascular guidelines in general practice has a high variance. As patients in primary care are often multimorbid, evidence-based recommendations often need to be tailored to the patient's needs. Guideline enhancement should therefore emphasize practicality, comprehensibility, and the incorporation of general practitioners' viewpoints.
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Zink et al. (2026) conducted a systematic review in Cardiovascular disease (n=37). Cardiovascular clinical practice guidelines was evaluated on Guideline adherence rate. Adherence to cardiovascular guidelines in general practice varied considerably, ranging from 4% to 100%, influenced by time constraints, systemic factors, and complex patient cases.
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