Are national cardiac guidelines being applied by Vascular surgeons?

Kevin Cassar, J. Belch, Julie Brittenden

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Introduction. National cardiac guidelines recommend that patients with intermittent claudication should be managed in the same way as those with established coronary heart disease. This survey aimed to determine the attitudes Of vascular consultants to risk factor management in new patients attending their out-patient clinic.

Methods. An anonymous postal questionnaire was sent to all 394 members of the Vascular Surgical Society in June 2002. Questions were asked about the following measures: serum cholesterol levels, the presence of diabetes, antiplatelet therapy, exercise regimens, blood pressure, thrombophilia, smoking and the availability of local guidelines and expertise.

Results. A response rate of 65% was obtained. Most (85%) consultants would measure a random cholesterol, but 34% would only treat claudicants if the cholesterol was greater than 5.5 mmol/l. Furthermore, 23% would inappropriately use diet alone as initial cholesterol lowering therapy. Over a quarter Of consultants would not screen for diabetes or measure blood pressure. Nearly all (99%) would recommend aspirin and 66% would recommend nicotine replacement therapy. Only 55% had access to a smoking cessation clinic, and 34% to a formal exercise program. The majority (56%) did not have local risk factor management guidelines, only 16% had access to a vascular physician, and 65% would prefer to have this expertise available for difficult cases.

Discussion. Management Of major risk factors was found to be sub-optimal. Thus guidelines for the prevention of coronary disease in clinical practice are not being applied to claudicants.

Original languageEnglish
Pages (from-to)623-628
Number of pages5
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume26
DOIs
Publication statusPublished - 2003

Keywords

  • intermittent claudication
  • risk factors
  • cholesterol
  • smoking
  • antiplatelet therapy
  • exercise
  • PERIPHERAL ARTERIAL-DISEASE
  • CORONARY HEART-DISEASE
  • INTERMITTENT CLAUDICATION
  • CARDIOVASCULAR EVENTS
  • CHOLESTEROL LEVELS
  • MEDICAL THERAPY
  • PREVENTION
  • PRAVASTATIN
  • SIMVASTATIN
  • POPULATION

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