Open AccessUnderutilisation of cardiovascular medications among at‐risk individuals
Author(s) -
Lewis S. J.,
Robinson J. G.,
Fox K. M.,
Grandy S.
Publication year - 2010
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/j.1742-1241.2009.02258.x
Subject(s) - medicine , stroke (engine) , diabetes mellitus , antithrombotic , myocardial infarction , risk factor , disease , medical prescription , family history , physical therapy , endocrinology , pharmacology , mechanical engineering , engineering
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.