Secondary prevention of myocardial infarction: a survey in primary care

Abstract

The preventive attitude of Italian general practitioners is similar to that reported in other European countries with two noticeable exceptions: under-prescription of beta-blockers and of antiplatelet drugs. Clearly, secondary prevention requires major improvement.

Office and 24-h ambulatory blood pressure control by treatment in general practice: the ‘Monitoraggio della pressione ARteriosa nella medicina TErritoriale’ study

“…However, the data obtained from large cohorts seen by general practitioners in Italy [3,4] and the lower BP thresholds for hypertension diagnosis recommended for ABP data [8] seem rather to suggest the occurrence of an opposite phenomenon, that is, a high number of hypertensive patients being inadequately managed because of insufficiently aggressive protocols, thus remaining at high risk of cardiovascular and cerebrovascular accidents.…”

“…This implies the achievement of the identified BP targets, currently set at levels below 140/ 90 mmHg in the office and below 125/80 mmHg over the 24 h [1][2][3]. General practitioners are expected to play a major role in the attempt to achieve BP normalization in hypertensive patients, but the results of their intervention are often reported as unsuccessful, at least in Italy [3,4].…”

“…This implies the achievement of the identified BP targets, currently set at levels below 140/ 90 mmHg in the office and below 125/80 mmHg over the 24 h [1][2][3]. General practitioners are expected to play a major role in the attempt to achieve BP normalization in hypertensive patients, but the results of their intervention are often reported as unsuccessful, at least in Italy [3,4]. Furthermore, focus of general practitioners is, in most cases, only on office BP measurements to estimate the degree of hypertension control [5], regardless of the increasing evidence on the advantages carried by use of 24-h ambulatory BP monitoring (ABPM) in this context [6,7] and of the reports on the different BP thresholds to be considered with this approach in relation to cardiovascular risk [8][9][10][11].…”