%0 Journal Article
%T Evidence-based cardiovascular care in the community: A population-based cross-sectional study
%A Wayne Putnam
%A Frederick I Burge
%A Beverley Lawson
%A Jafna L Cox
%A Ingrid Sketris
%A Gordon Flowerdew
%A David Zitner
%J BMC Family Practice
%D 2004
%I BioMed Central
%R 10.1186/1471-2296-5-6
%X We conducted a two-year cross-sectional study involving all hospitals in the province of Nova Scotia, Canada. Subjects were all patients admitted with ischaemic heart disease with or without congestive heart failure between 15 October 1997 and 14 October 1999. The main measure was the previous outpatient use of recommended medications. Chi-square analyses followed by multivariate logistic regression analyses were used to examine age-sex differences.Usage of recommended medications varied from approximately 60% for beta-blockers and angiotensin converting enzyme (ACE) inhibitors to 90% for antihypertensive agents. Patients aged 75 and over were significantly less likely than younger patients to be taking any of the medication classes. Following adjustment for age, there were no significant differences in medication use by sex except among women aged 75 and older who were more likely to be taking beta-blockers than men in the same age group.The use of evidence-based cardiovascular medications is rising and perhaps approaching reasonable levels for some drug classes. Family physicians should ensure that all eligible patients (prior myocardial infarction, congestive failure) are offered beta-blockers or ACE inhibitors.Ischaemic heart disease (IHD) and congestive heart failure (CHF) are conditions commonly encountered in primary care, and optimal management by family physicians (FPs) in concert with other health care providers should increase the chance of an optimal patient outcome. In recent years, the ability of FPs to enhance their patients' outcomes has increased markedly, with large randomized controlled trials demonstrating the value in patients with IHD of beta blocking agents (BBs), antithrombotic agents and antilipemic agents, and angiotensin converting enzyme (ACE) inhibitors in patients who also have moderate to severe left ventricular dysfunction. This evidence was summarized, and the benefit of treating hypertension in patients with IHD to target levels was
%U http://www.biomedcentral.com/1471-2296/5/6