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Reducing risk in coronary artery disease. Are A ustralian patients in general practice achieving targets? The C oronary A rtery D isease in general practice study (CADENCE)
Author(s) -
Driscoll A.,
Beltrame J.,
Beauchamp A.,
Morgan C.,
Weekes A.,
Tonkin A.
Publication year - 2013
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2012.02929.x
Subject(s) - medicine , body mass index , blood pressure , waist , coronary artery disease , risk factor , cohort , framingham risk score , angina , disease , physical therapy , cardiology , myocardial infarction
Abstract Background The benefits of secondary preventive measures for stable coronary artery disease are well established and risk factor treatment targets are defined. Aim The aim of this study was to examine A ustralian general practitioners' ( GP ) perception and management of risk factors in chronic stable angina patients in primary care. Methods Using a cluster‐stratified design, 2031 consecutive stable angina patients were recruited between O ctober 2006 and M arch 2007 by 207 GP who documented their risk factors and reported if they were optimally controlled. Results Among the patients, 93% had objective evidence of coronary artery disease and 63% were male, and mean age was 71 ± 11 years. Based upon national guidelines, recommended targets were achieved in: 60% for blood pressure, 24% for body mass index, 23% for waist circumference, 17% for lipid profiles (low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol and triglycerides) and 54% of diabetics for haemoglobin A 1c . However, GP perceived risk factors to be ‘optimally controlled’ in: 86% for blood pressure (kappa statistic (κ) = 0.37), 44% for weight (κ = 0.3), 70% for lipids (κ = 0.20) and 60% for haemoglobin A 1c (κ = 0.74). Conclusions In this representative cohort of chronic stable angina patients attending GP , cardiovascular risk factor control was frequently suboptimal despite being perceived as satisfactory by the clinicians. New strategies that raise awareness and address this treatment gap need to be implemented.