Goal attainment for multiple cardiovascular risk factors in community‐based clinical practice (a Canadian experience)

Farahani, Pendar; Levine, Mitchell

doi:10.1111/j.1365-2753.2008.01002.x

Cited by 8 publications

(4 citation statements)

References 23 publications

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“…Even for patients who did not achieve the aggressive LDL target of <2.0 mmol/L, their mean LDL was only slightly (mean of 0.43 mmol/L) above target. Similarly, the proportion of patients achieving the blood pressure goal (79%) is higher than that reported for the general population (57% -58%) [35] [37]. For those who did not achieve the goal, their BP readings were only 1 -6 mmHg above their target.…”

Section: Discussionmentioning

confidence: 73%

Evaluation of the Management of Hyperlipidemia and Hypertension in an Outpatient Cardiac Transplant Clinic

Xu¹,

Burton²,

Tymchak³

et al. 2016

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Background: Allograft coronary artery disease (ACAD) is a common cause of morbidity and mortality post-orthotopic heart transplantation (OHT). ACAD progression may be reduced by modifying cardiovascular risk factors, such as hyperlipidemia and hypertension. We sought to evaluate the management of hyperlipidemia and hypertension among OHT recipients followed in an outpatient cardiac transplant clinic. Objective: The primary objective was to assess the proportion of OHT patients achieving both the recommended LDL target of <2.0 mmol/L and BP targets of <140/90 mmHg (or <130/80 mmHg for diabetics) in an outpatient cardiac transplant clinic. Methods: A cross-sectional retrospective analysis of the medical records of all adult OHT recipients actively followed in our outpatient cardiac transplant between January-March 2009. Results: Of the 193 patients included, both the low-density lipoprotein (LDL) cholesterol and blood pressure (BP) targets were achieved in 111 (57.5%) patients. The LDL target alone was achieved by 140 (72.5%) patients and the BP target alone by 153 (79.3%) patients. Statins were prescribed in 183 (94.8%) patients with a mean LDL of 1.81 mmol/L (±0.55). Angiotensin converting enzyme-inhibitors [ACE-I] (or angiotensin receptor blockers [ARB]) were prescribed in 154 (79.8%) patients, diltiazem in 101 (52.3%) patients, and both in 85 (44.0%) patients, with a mean BP of 124.2/77.8 mmHg (±13.6/8.2). Adverse reactions related to statins, ACE-inhibitors or diltiazem were uncommon and rarely resulted in drug discontinuation. Conclusions: Guideline recommended that LDL and BP targets are achievable in a significant proportion of OHT recipients. The high utilization rates of statins for dyslipidemia and ACE-I (or ARB) and diltiazem for BP were consistent with guideline recommendations for the prevention of ACAD. Despite concerns regarding the potential for pharmacokinetic drug interactions in OHT patients, the reported rates of any drug intolerance to these medications were low in our population.

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Section: Discussionmentioning

confidence: 73%

Evaluation of the Management of Hyperlipidemia and Hypertension in an Outpatient Cardiac Transplant Clinic

Xu¹,

Burton²,

Tymchak³

et al. 2016

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“…Finally, how does the continued research investigating bowel preparation translate into the “real world”? Little to no evidence exists in this realm for colonoscopy, although in other fields when compared with the real world it almost always displays poorer results [ 8 – 10 ]—likely a combination of less patient education, broader patient group, and variation in instructions/prescribing behaviour. Development of patient education and reminder tools is necessary to try to offset these effects.…”

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confidence: 99%

Assessing Bowel Cleansing for Colonoscopy: Changing Our Focus to What Really Matters

Hookey

2016

Canadian Journal of Gastroenterology and Hepatology

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“…Methodology e data were derived from a previous cross-sectional study [6,7]. Patients lling a prescription for a lipid-lowering drug between September 2004 and June 2005 in selected pharmacies in Nova Scotia, uebec, Ontario and British Columbia were eligible to participate in this study.…”

mentioning

confidence: 99%

Household income and LDL-C goal attainment in patients with diabetes and dyslipidemia in a Canadian dataset

Farahani¹,

Levine²

2014

CIM

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Household income and LDL-C goal attainment in patients with diabetes and dyslipidemia in a Canadian dataset Abstract Purpose: ere is evidence of a social disparity pertaining to the epidemiology and burden of illness of diabetes.e purpose of this study was to assess the association between household income strata and therapeutic goal achievement rates for LDL-cholesterol (LDL-C) (< 2.5 mmol/L) in Canadian diabetic patients.Methods: Data (household income, cardiovascular risk factors, drug pro le, clinical and laboratory variables) were obtained from a previous cross-sectional study of diabetic patients who lled a prescription for a lipid-lowering drug in selected pharmacies across Canada. Telephone interviews were conducted. Physicians, identi ed by the participating patients, were requested to complete a short questionnaire for clinical data. Achievement of LDL-C goals according to the Canadian diabetes guidelines were assessed and incorporated into regression models corresponding to household income strata.Results: Seven household income strata were de ned in the cohort (from less than 20,000 CDN$, up to 70,000 CDN$ by increments of 10,000 CDN$). LDL-C goals were attained in 34% of patients in the total cohort. ere were no signi cant di erences amongst household income strata for LDL-C goal achievement (p = 0.80). ere were no signicant di erences in patient characteristics (age, sex, BMI) and cardiovascular risks according to the household income strata in this cohort, except age more than 65 in the lower income strata.Conclusion: is study demonstrates that household income was not a factor to achieve therapeutic goals for LDL-C for patients with diabetes in this dataset, although goal attainment was less than ideal overall. Future studies should address limitations of this work including small sample size, recruitment bias and lack of data on third party insurance coverage.

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Goal attainment for multiple cardiovascular risk factors in community‐based clinical practice (a Canadian experience)

Cited by 8 publications

References 23 publications

Evaluation of the Management of Hyperlipidemia and Hypertension in an Outpatient Cardiac Transplant Clinic

Evaluation of the Management of Hyperlipidemia and Hypertension in an Outpatient Cardiac Transplant Clinic

Assessing Bowel Cleansing for Colonoscopy: Changing Our Focus to What Really Matters

Household income and LDL-C goal attainment in patients with diabetes and dyslipidemia in a Canadian dataset

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