Charles Darwin University

CDU eSpace
Institutional Repository

 
CDU Staff and Student only
 

Disparities between prescribing of secondary prevention therapies for stroke and coronary artery disease in general practice

Heeley, Emma, Anderson, Craig, Patel, Anushka, Cass, Alan, Peiris, David, Weekes, Andrew and Chalmers, John (2012). Disparities between prescribing of secondary prevention therapies for stroke and coronary artery disease in general practice. International Journal of Stroke,7(8):649-654.

Document type: Journal Article

IRMA ID 84473293xPUB42
Title Disparities between prescribing of secondary prevention therapies for stroke and coronary artery disease in general practice
Author Heeley, Emma
Anderson, Craig
Patel, Anushka
Cass, Alan
Peiris, David
Weekes, Andrew
Chalmers, John
Journal Name International Journal of Stroke
Publication Date 2012
Volume Number 7
Issue Number 8
ISSN 1747-4930   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84869058457
Start Page 649
End Page 654
Total Pages 5
Place of Publication United Kingdom
Publisher Sage Publications Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Extensive evidence exists regarding the effectiveness of secondary prevention measures in patients with cardiovascular disease.

Aim
We aimed to examine the management and risk perceptions of cardiovascular events in people with established cardiovascular disease.

Methods

We analyzed data on 1453 patients, ≥55 year old, with a history of cardiovascular disease, from the Australian Hypertension and Absolute Risk Study.

Results
Compared with those 533 patients with stroke/transient ischemic attack, the 743 patients with coronary artery disease were twice as likely to have been prescribed secondary prevention therapies even after adjustment for potential confounding variables (adjusted relative risks 1·85; 95% confidence interval 1·56–2·19, 42% vs. 73% for use of the combination of blood pressure-lowering, lipid-lowering and antiplatelet therapies) and to have better control of lipid and blood pressure levels. General practitioners estimated that only 27% of patients with stroke/transient ischemic attack – 38% of those with coronary artery disease and 41% of those with both conditions – were at a high risk (≥15%) of a recurrent event. Patients similarly underestimated their risk of recurrent cardiovascular events, with only 8% of stroke/transient ischemic attack, 11% of coronary and 15% of combination disease patients rating themselves at ‘high’ or ‘very-high’ risk.

Conclusions
This study reaffirms the large treatment gap in the uptake of secondary prevention for cardiovascular disease in primary care settings, being much greater for patients with cerebral compared with cardiac cardiovascular disease. This appears to be related to differential perceptions of cardiovascular risk across different vascular territories in both patients and doctors.
Keywords cardiovascular disease
general practice
myocardial infarction
risk perception
secondary prevention
stroke
DOI http://dx.doi.org/10.1111/j.1747-4949.2011.00613.x   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
Versions
Version Filter Type
Access Statistics: 10 Abstract Views  -  Detailed Statistics
Created: Tue, 24 Feb 2015, 12:29:15 CST