Reducing risk in coronary artery disease. Are Australian patients in general practice achieving targets? The coronary artery disease in general practice study (CADENCE)

Andrea Driscoll, John Beltrame, Alison Beauchamp, Claire Morgan, Andrew Weekes, Andrew Tonkin

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    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 Australian 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 October 2006 and March 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 A1c. 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 A1c (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.

    Original languageEnglish
    Pages (from-to)526-531
    Number of pages6
    JournalInternal Medicine Journal
    Volume43
    Issue number5
    DOIs
    Publication statusPublished - May 2013

    Keywords

    • Angina, cardiovascular risk factor
    • Coronary artery disease
    • Primary care
    • Secondary prevention.

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