Suboptimal management of cardiovascular risk factors in coronary heart disease patients in primary care occurs particularly in women

Driscoll, A., Beauchamp, A., Lyubomirsky, G., Demos, L., McNeil, J. and Tonkin, A. 2011, Suboptimal management of cardiovascular risk factors in coronary heart disease patients in primary care occurs particularly in women, Internal medicine journal, vol. 41, no. 10, pp. 730-736, doi: 10.1111/j.1445-5994.2011.02534.x.

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Title Suboptimal management of cardiovascular risk factors in coronary heart disease patients in primary care occurs particularly in women
Author(s) Driscoll, A.ORCID iD for Driscoll, A. orcid.org/0000-0002-6837-0249
Beauchamp, A.ORCID iD for Beauchamp, A. orcid.org/0000-0001-6555-6200
Lyubomirsky, G.
Demos, L.
McNeil, J.
Tonkin, A.
Journal name Internal medicine journal
Volume number 41
Issue number 10
Start page 730
End page 736
Total pages 7
Publisher Wiley - Blackwell Publishing Asia
Place of publication Richmond, Vic.
Publication date 2011-10
ISSN 1444-0903
1445-5994
Keyword(s) coronary heart disease
primary care
risk factor
Summary Background:  Patients with established coronary heart disease (CHD) are at the highest risk of further events. Despite proven therapies, secondary prevention is often suboptimal. General practitioners (GPs) are in an ideal position to improve secondary prevention.

Aim:  To contrast management of cardiovascular risk factors in patients with established CHD in primary care to those in clinical guidelines and according to gender.

Methods:  GPs throughout Australia were approached to participate in a programme incorporating a disease management software (mdCare) program. Participating practitioners (1258 GPs) recruited individual patients whose cardiovascular risk factor levels were measured.

Results:  The mdCare programme included 12 509 patients (58% male) diagnosed with CHD. Their mean age was 71.7 years (intra-quartile range 66–78) for men and 74 years (intra-quartile range 68–80) for women. Low-density-lipoprotein cholesterol was above target levels in 69% (2032) of women compared with 58% (2487) in men (P < 0.0001). There was also a higher proportion of women with total cholesterol above target levels (76%, 3592) compared with men (57%, 3787) (P < 0.0001). In patients who were prescribed lipid-lowering medication, 53% (2504) of men and 72% (2285) of women continued to have a total cholesterol higher than recommended target levels (P < 0.0001). Overall, over half (52%, 6538) had at least five cardiovascular risk factors (55% (2914) in women and 50% (3624) in men, P < 0.0001).

Conclusion:  This study found less intensive management of cardiovascular risk factors in CHD patients, particularly among women, despite equivalent cardiovascular risk. This study has shown that these patients have multiple risk factors where gender also plays a role.
Language eng
DOI 10.1111/j.1445-5994.2011.02534.x
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2011, Wiley-Blackwell Publishing Asia
Persistent URL http://hdl.handle.net/10536/DRO/DU:30046463

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