Current state of angina treatment in the outpatient population and heart rate monitoring survey in Latvia (RELITY LATVIA) The aim of the REALITY Latvia survey was to accumulate information about treated stable angina outpatients regarding their characteristics, heart rate (HR), treatment, and quality of life. Thirty cardiologists were involved with 1-15 patients each. In total, data about 300 patients were obtained. Patients were examined and questioned during one visit. A high HR was defined above 70 beats per minute (bpm), in accordance to recent evidence. Mean HR was 70.3 ± 11.3 bpm and 45% of patients had HR above 70 bpm. The opinion of practitioners regarding HR differed. For example, a HR level within the range 70-80 bpm was perceived by cardiologists as "normal", "borderline high" and "high". The mean target HR that physicians wanted to achieve was 60.1 ± 4.7 bpm. Beta blockers were used in 91% of cases. The more widely used beta blockers were metoprolol (47%) and bisoprolol (35%) in mean daily doses 69.7 ± 30.1 mg and 5.3 ± 2.0 mg, respectively. REALITY Latvia data suggest that, despite wide use of beta blockers, HR control in stable angina patients is insufficient. This is caused by insufficient understanding of HR as a treatment target by physicians and use of beta blockers in suboptimal dosages.

Latvian CAD patients are well managed in terms of aspirin use and frequency of percutaneous coronary intervention. Control of obesity and high BP is poorer and needs further improvement.

Contributed by Andrejs ÇrglisThe aim of the study was to characterise coronary artery disease (CAD)

Despite the wide use of beta-blockers, HR is insufficiently controlled in the analyzed sample of stable CAD patients in Latvia. Target HR ≤60bpm is achieved only in 25% of the patients while more than one third have increased HR ≥70bpm.

The aim of the study was to evaluate control of heart rate (HR) and other risk factors (RF) over athree-year period in coronary artery disease (CAD) outpatients in Latvia. Patients (n = 120) were examined and questioned at baseline time and annually (four times in total). Increased resting HR (≥70 bpm) when measured by palpation was present in 35.8% of cases at baseline time, 35.6%, 29.8% and 35.1% of cases at Y1, Y2 and Y3, respectively; when measured by electrocardiography: in 33.6% (baseline), 36.8% (Y1), 26.7% (Y2), 33.7% (Y3) of cases. The proportion of patients with increased HR did not significantly change in Y1–Y3 vs baseline. Systolic blood pressure was lower in Y1 and Y3 vs baseline (P = 0.005 and P = 0.003, respectively). The proportion of patients with increased blood pressure (≥140/90 mmHg) was lower in Y1, Y2 and Y3 than at baseline (P = 0.018, P = 0.030 and P = 0.017, respectively). The proportion of patients with a decreased level of high density lipoprotein cholesterol (<1.2 mmol/l for women and <1.0 mmol/l fom men) was lower in Y1–Y3 compared to baseline (P < 0.001). A substantial (about one-third) and stable proportion of patients with increased HR≥70 bpm over the three-year period in the examined sample of treated CAD patients indicates that there is a need for better control of this RF.