Discordance Between Physicians' Estimation of Patient Cardiovascular Risk and Use of Evidence-Based Medical Therapy

Despite clinical trial evidence supporting the use of antiplatelets, angiotensin-converting enzyme inhibitors, and statins for cardiovascular risk reduction in high-risk patients, use of such therapies in real-world outpatients in the prospective Vascular Protection Registry and the Guidelines Orien...

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Bibliographic Details
Published in:The American journal of cardiology 2008-11, Vol.102 (9), p.1142-1145
Main Authors: Tsang, Jennifer L.Y., MD, Mendelsohn, Aurora, PhD, Tan, Mary K.K., BSc, Hackam, Daniel G., MD, Leiter, Lawrence A., MD, Fitchett, David, MD, Lin, Peter J., MD, Grima, Etienne, BSc, Langer, Anatoly, MD, MSc, Goodman, Shaun G., MD, MSc
Format: Article
Language:English
Subjects:
ACE inhibitors
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Cardiology
Cardiology. Vascular system
Cardiovascular
Cardiovascular disease
Cardiovascular Diseases - drug therapy
Cardiovascular Diseases - prevention & control
Clinical Competence
Drug therapy
Evidence-Based Medicine
Female
Guideline Adherence
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Medical sciences
Platelet Aggregation Inhibitors - therapeutic use
Professional Practice
Risk Assessment
Risk Factors
Treatment Outcome
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Summary:Despite clinical trial evidence supporting the use of antiplatelets, angiotensin-converting enzyme inhibitors, and statins for cardiovascular risk reduction in high-risk patients, use of such therapies in real-world outpatients in the prospective Vascular Protection Registry and the Guidelines Oriented Approach to Lipid Lowering Registry was suboptimal (78%, 55%, and 75%, respectively). The most frequent reason physicians cited for nonprescription of statins (33%) was that patients were not high risk enough and/or current guidelines did not support statin use. In conclusion, outpatients at high cardiovascular risk continue to be undertreated as a result of a combination of physician underestimation of cardiovascular risk (knowledge gap) and barriers to implementation of evidence-based therapy (practice gap).
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2008.06.037