Uptake of best medical therapy: Secondary prevention of cardiovascular disease in vascular surgical patients in Western Australia

Document Type

Journal Article

Publication Title

Angiology

PubMed ID

36927174

Publisher

Sage

School

School of Medical and Health Sciences

RAS ID

56580

Comments

Teh, R., Raymond, W., & Sieunarine, K. (2023). Uptake of best medical therapy: Secondary prevention of cardiovascular disease in vascular surgical patients in Western Australia. Angiology. Advance online publication. https://doi.org/10.1177/00033197231159246

Abstract

Best medical therapy (BMT) for peripheral arterial disease (PAD), carotid artery stenosis (CAS) and abdominal aortic aneurysm (AAA) involving concomitant use of antiplatelets, lipid-lowering agents, and blood pressure control, improves patient survival and prevents clinical cardiovascular disease (CVD). We performed a single-center cross-sectional study, over a 4-year period, describing BMT use in Western Australian patients with symptomatic PAD, CAS and AAA in the community. Overall, 45.3% of our cohort (n = 1689) were on appropriate BMT (CAS, 58.1%; PAD, 43.1%; AAA, 41.1%). There was highest uptake of blood pressure control at 93.0% (lipid-lowering agents, 65.3%; antithrombotics 63.5%). PAD was associated with highest uptake of blood pressure control (PAD 93.9%; CAS, 91.4%; AAA, 91.1%, P =.092) whilst CAS had highest uptake of antithrombotics (CAS 76.3%; PAD, 61.0%; AAA 60.4%, P < .001) and lipid-lowering agents (CAS 78.7%; PAD, 63.1%; AAA, 60.4%, P < .001). Our study indicates suboptimal use of BMT in patients with vascular disease in the community. The risk of CVD in CAS is likely misperceived as higher than PAD and AAA.

DOI

10.1177/00033197231159246

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