Meeting AHA/ACC secondary prevention goals in a vascular surgery practice: An opportunity we cannot afford to miss

Kinikini, Daniel V.; Sarfati, Mark R.; Mueller, Michelle T.; Kraiss, Larry W.

doi:10.1016/j.jvs.2005.12.002

Cited by 23 publications

(20 citation statements)

References 49 publications

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“…15,[21][22][23][24][25][26][27][28][29][30] Even in ideal conditions, the success rates in reaching national targets are dismal. In a study of a socioeconomically homogeneous, multiethnic, well-educated population with comprehensive medical benefits, Ͼ80% failed to achieve blood pressure control despite full access to and active participation in the community's medical care system.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence shows patients are more likely to improve compliance after a surgical intervention, and vascular surgeons are uniquely influential in improving medical care. 21 At our university, the monthly cost of a combination of aspirin, lisinopril, metoprolol, and rosuvastatin is as low as $20. Instituting a policy of aggressive medical management in all vasculopathic patients may prove to be cost-effective considering the cost of a single nonfatal myocardial infarction or a single nondisabling stroke.…”

Section: Discussionmentioning

confidence: 99%

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Uninsured South Florida vascular surgery patients are less likely to receive optimal medical management than their insured counterparts

Yeh

Jones

Schulman

et al. 2010

Journal of Vascular Surgery

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Compliance with optimal medical therapy for secondary risk factor management amongst our vascular surgery patients is low. Uninsured patients are less likely to receive optimal medical therapy than their insured counterparts. This survey provides sobering statistics regarding medical compliance in our population. This issue deserves further study and may indirectly affect outcomes in minority groups that are disproportionately represented in our uninsured patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Uninsured South Florida vascular surgery patients are less likely to receive optimal medical management than their insured counterparts

Yeh

Jones

Schulman

et al. 2010

Journal of Vascular Surgery

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“…64 One of the earliest groups of drugs to be tested for any association with AAA growth or rupture were beta-blockers, but although laboratory models 65,66 provided encouraging evidence of a beneficial effect this has not translated convincingly into the general AAA population, 67 although some benefit has been seen in patients with Marfan syndrome. 68 Angiotensin converting enzyme (ACE) inhibitors are also thought to provide benefit to patients with AAA [69][70][71] but there is little evidence on their relationship with rupture and growth rates, 64,72 and there is some evidence to suggest that the use of ACE inhibitors may be harmful in these patients. 73,74 Non-steroidal anti-inflammatory drugs, and, in particular, cyclo-oxygenase-2 (COX-2) inhibitors, have also been suggested as an agent for reducing AAA growth rate 75 but this finding has not been reproduced consistently in other patient series.…”

Section: Medical Therapymentioning

confidence: 99%

The UK EndoVascular Aneurysm Repair (EVAR) trials: randomised trials of EVAR versus standard therapy.

Brown

Powell²,

Thompson³

et al. 2012

Health Technol Assess

206

170

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects...

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“…There are several possible explanations for our findings. First, the association of PAD and CAD is usually unrecognized by both patients and primary care physicians,28 and a significant number of patients with PAD may not have symptoms related to their CAD 15. Second, there may be gaps between what physicians know they should do, and what they actually do, to manage risk factors in patients with PAD 29–31.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the efficacy of these techniques, several expert committees have recommended their use in patients with PAD 12–14. Despite this, several studies have documented the underuse of risk reduction therapies in patients with PAD 15–23…”

mentioning

confidence: 99%

Suboptimal use of risk reduction therapy in peripheral arterial disease patients at a major teaching hospital

Al‐Omran

Verma

Lindsay

2011

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVES:Current evidence suggests that modification of atherosclerosis risk factors plays an important role in reducing adverse cardiovascular outcomes in patients with peripheral arterial disease (PAD). This study was undertaken to determine whether patients in this high-risk group were adequately using risk factor modification therapy.DESIGN AND SETTING:Prospective study of consecutive patients with PAD from a teaching hospital.PATIENTS AND METHODS:The collected data included information about atherosclerotic risk factors and utilization of risk factor modification therapyRESULTS:The 391 patients had a mean (standard deviation of 3 (1) atherosclerotic risk factors. Hypertension was identified in 56.8% of patients (222/391), of whom only 37.4% (83/222) had adequate blood pressure control (BP <140/90 mm Hg). The prevalence of diabetes mellitus (DM) was 35 % (137/391). Among patients with DM, only 49% (67/137) had adequate blood glucose control (glycosylated hemoglobin, HbA1c <7%). Statins were currently prescribed in 61% of patients (238/391), 38.7% (92/238) of whom continued to have low-density lipoprotein (LDL) >2.5 mmol/L, compared to a rate of 76.5% (117/153) among non-statin users (P<.001). The majority of patients of patients ( 72.4%; 283/391) were overweight/obese. Many patients (67.3%; 263/391) were nonsmokers; however, most (73.4%; 193/263) had a history of smoking. Antiplatelets were prescribed for 78.3% of patients (306/391), of whom 70.6% (216/306) were taking aspirin. Angiotensin converting enzyme (ACE) inhibitors were prescribed for 44.8% of patients (175/391). Among rampril users, only 36.8% of patients (53/144) were on an optimal dose.CONCLUSION:Although atherosclerotic risk factors were prevalent in patients with PAD, we found that patients received sub-optimal use of risk reduction treatments. Effective strategies to encourage health professionals to use these adjunctive therapies need to be developed.

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Meeting AHA/ACC secondary prevention goals in a vascular surgery practice: An opportunity we cannot afford to miss

Cited by 23 publications

References 49 publications

Uninsured South Florida vascular surgery patients are less likely to receive optimal medical management than their insured counterparts

Uninsured South Florida vascular surgery patients are less likely to receive optimal medical management than their insured counterparts

The UK EndoVascular Aneurysm Repair (EVAR) trials: randomised trials of EVAR versus standard therapy.

Suboptimal use of risk reduction therapy in peripheral arterial disease patients at a major teaching hospital

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