Cardiovascular treatment gaps: closing, but slowly.
OBJECTIVE
To measure trends in the cardiovascular preventive medication prescribing in New Zealand primary care during 2000-2003.


METHODS
Demographic, risk factor, and prescribing data from the Dunedin Royal New Zealand College of General Practitioners Research Unit database were analysed. The data set consisted of men aged at least 45 years and women at least 55 years, who consulted a doctor in 2000-2003 in a practice that supplied electronic clinical notes (total number varied by year from 24,292 to 30,842).


RESULTS
Cardiovascular risk (as calculated by the Framingham-based [Anderson] risk equation) could only be estimated for one-third of the study population due to missing risk factor information. In 2000, prescription of both blood pressure- and cholesterol-lowering medications occurred in 28% of people with established vascular disease and 14-16% of people without vascular disease but with a 5-year cardiovascular risk over 5%. From 2000 to 2003, the treatment of all patient groups with a 5-year cardiovascular risk of >10% (vascular history or not) increased by about 4% per year. Those in the 5-10% cardiovascular risk bracket increased treatment by about 3% per year.


CONCLUSIONS
Cardiovascular medicine treatment gaps in primary care reduced between 2000 and 2003 but a significant gap persisted. There is only modest evidence that treatment rates are targeted to estimated cardiovascular risk. Data on the prescription of these medications by cardiovascular risk needs to be collected, analysed, and disseminated on an ongoing basis to enable close monitoring of strategies to improve cardiovascular risk assessment and management.
Selak
Vanessa
V
Planning and Funding Team, Waitemata District Health Board, Private Bag 93503, Takapuna, North Shore 0740, New Zealand. vanessa.selak@waitematadhb.govt.nz
Rafter
Natasha
N
Parag
Varsha
V
Tomlin
Andrew
A
Vander Hoorn
Stephen
S
Dovey
Susan
S
Rodgers
Anthony
A
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D004232:Diuretics / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002317:Cardiovascular Agents; D004232:Diuretics; D000960:Hypolipidemic Agents