Underutilisation of cardiovascular medications among at-risk individuals
| Autor: | S J, Lewis, J G, Robinson, K M, Fox, S, Grandy, Helena W, Rodbard |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Prescription Drugs Heart disease Disease Cardiovascular Fibrinolytic Agents Risk Factors Diabetes mellitus Internal medicine Medicine Humans Myocardial infarction cardiovascular diseases Risk factor National Cholesterol Education Program Stroke Antihypertensive Agents Cause of death Hypolipidemic Agents business.industry General Medicine Patient Acceptance of Health Care medicine.disease Cardiovascular Diseases Practice Guidelines as Topic Physical therapy Female business |
| Zdroj: | International Journal of Clinical Practice |
| ISSN: | 1742-1241 1368-5031 |
| Popis: | SUMMARY Aims: Guidelines recommend antihypertensive, lipid-lowering and ⁄or antiplatelet therapy for prevention of cardiovascular disease (CVD). This study examined the utilisation of cardiovascular therapies among individuals at CVD risk to assess adherence to guidelines. Methods: Respondents to the SHIELD study were classified based on National Cholesterol Education Program Adult Treatment Panel III risk categories. High coronary heart disease (CHD) risk (n = 7510) was defined as self-reported diagnosis of heart disease ⁄heart attack, narrow or blocked arteries, stroke or diabetes; moderate risk (n = 4823) included respondents with ‡ 2 risk factors (i.e., men > 45 years, women > 55 years, hypertension, low high-density lipoprotein cholesterol, smoking and family history of CHD); and low risk (n = 5307) was 0‐1 risk factor. Respondents reporting a myocardial infarction, stroke or revascularisation at baseline (prior CVD event) (n = 3777), those reporting a new CVD event during 2 years of follow up (n = 953), and those with type 2 diabetes mellitus (n = 3937) were evaluated. The proportion of respondents reporting treatment with lipid-lowering, antiplatelet or antihypertensive agents was calculated. Results: Utilisation of lipid-lowering therapy was low (£ 25%) in each group. Prescription antithrombotic therapy was minimal among respondents with prior CVD events, but 47% received antihypertensive medication. No use before or after a new CVD event was reported by 36% of respondents for lipid-lowering, 32% for antithrombotic and > 50% for antihypertensive medications. Conclusions: More than 50% of at-risk respondents and > 33% of respondents with new CVD events were not taking CVD therapy as recommended by guidelines. What’s known Cardiovascular disease is a prevalent condition that is the leading cause of death in the United States and several national guidelines provide recommendations for the treatment and prevention of cardiovascular disease in routine clinical practice. What’s new This study highlights the gap in the utilisation of cardiovascular drug therapies, including statins, antiplatelet ⁄anticoagulant and anti-hypertensive agents among respondents with high and moderate coronary heart disease risk and those with a prior cardiovascular event or new incident event. The findings indicate that the treatment guidelines have not been translated into clinical practice for many individuals at risk of cardiovascular disease. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|