title: Suboptimal preventive practices in patients with carotid and peripheral vascular occlusive disease in a tertiary referral setting.
abstract: BACKGROUND
  Effective strategies for the prevention of adverse vascular events in patients with atherosclerotic vascular disease include smoking cessation, platelet inhibition, antihypertensives, hypoglycaemic and cholesterol lowering agents. The current literature suggests that these practices are suboptimal in patients with peripheral vascular disease (PVD). This study aims to examine and compare the use of preventive therapy in patients admitted for interventions related to peripheral and carotid atherosclerotic occlusive disease.
  
  
  METHODS
  All inpatients undergoing diagnostic or therapeutic procedures for occlusive disease of the lower limb and carotid artery at Royal Perth Hospital, Western Australia, between January 2000 and December 2000 were included in the study. Their medical charts were reviewed to measure the prevalence of the use of antithrombotic, antihypertensive and cholesterol-lowering therapies.
  
  
  RESULTS
  Medical charts of 256 patients (97%) were reviewed during the study period. Carotid related procedures accounted for 26% of the sample. Overall, 80% were prescribed antithrombotic (antiplatelet or anticoagulation) therapy at the time of discharge. In the carotid group, 97% were on some form of antithrombotic therapy as opposed to 75% in the PVD group. Antihypertensive and cholesterol lowering therapies were used in 82% and 63%, respectively, of the carotid group vs 68% and 36% in the PVD group. Rates of preventive practices were lowest in the subgroup of PVD patients without a history of coronary or cerebrovascular disease.
  
  
  CONCLUSIONS
  Preventive therapies are under utilized in patients with PVD. Effective strategies need to be developed to encourage the use of these adjunctive therapies in the long-term management of vascular patients.
authors: Department of Vascular Surgery, Royal Perth Hospital, Perth, Western Australia, Australia. kishore@cyllene.uwa.edu.au
authors: Lip
authors: L
authors: Gen Teh
authors: Kishore
authors: K
authors: Sieunarine
authors: John
authors: J
authors: Eikelboom
authors: Frank J
authors: FJ
authors: Prendergast
authors: Marcel A
authors: MA
authors: Goodman
authors: Karen
authors: K
authors: Joesbury
authors: Eilidth
authors: E
authors: Watt
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001161:Arteriosclerosis / Q000188:drug therapy / Q000517:prevention & control* / Q000601:surgery; D016893:Carotid Stenosis / Q000188:drug therapy / Q000517:prevention & control* / Q000601:surgery; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D016491:Peripheral Vascular Diseases / Q000188:drug therapy / Q000517:prevention & control* / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents