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Prescribing and emergency admissions for heart failure in greater Glasgow
A P Davie1, C E Morrison, J E Forrester
1University of Glasgow, United Kingdom.
Insights
Angiotensin-converting enzyme (ACE) inhibitors are underprescribed. This study found no evidence that ACE inhibitors influence heart failure hospitalization rates, despite their underuse.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Heart failure remains a significant public health concern.
- Understanding factors influencing heart failure hospitalizations is crucial for effective management.
- The role of specific cardiovascular medications, like ACE inhibitors, requires ongoing investigation.
Purpose of the Study:
- To investigate the association between the prescription rates of angiotensin-converting enzyme (ACE) inhibitors and heart failure hospitalization rates.
- To explore the relationship between the use of diuretics, digoxin, and ACE inhibitors in primary care settings.
Main Methods:
- A cross-sectional study was conducted, linking prescribing data with hospital admission data.
- Data were collected from 215 primary health care practices in Greater Glasgow, UK.
- Prescription rates for diuretics, ACE inhibitors, and digoxin were analyzed alongside heart failure admission rates.
Main Results:
- A strong association was observed between diuretic and digoxin prescription rates.
- A moderate inverse association was found between the ratio of ACE inhibitor to diuretic prescriptions and heart failure admissions.
- The mean ACE inhibitor prescription rate was 0.06 per patient per year.
Conclusions:
- Angiotensin-converting enzyme (ACE) inhibitors are underutilized in the studied population.
- Diuretic and digoxin prescription rates correlate strongly, likely indicating similar underlying cardiovascular morbidity.
- No evidence emerged to suggest that ACE inhibitors modulate the rate of heart failure admissions.
Background:
We sought to determine whether there is an association between the rate of prescription of angiotensin-converting enzyme (ACE) inhibitors and the rate of hospitalization for heart failure.
Methods And Results:
We conducted a cross-sectional study linking prescribing data with hospital admission data from 215 primary health care practices in Greater Glasgow, United Kingdom. We obtained numbers of prescriptions of diuretics. ACE inhibitors, and digoxin and numbers of admissions for heart failure. The mean practice rate of diuretic prescription was 0.7 per patient per year, the mean practice rate of ACE inhibitor prescription was 0.06 per patient per year, the mean practice rate of digoxin prescription was 0.09 per patient per year, and the mean practice rate of admission for heart failure was 3.29 per 1,000 patients per year. There was a strong and significant association between the rate of diuretic prescription and the rate of digoxin prescription. There was only a moderate inverse association between the ratio of ACE inhibitor to diuretic prescriptions and the rate of admissions for heart failure.
Conclusions:
ACE inhibitors are underused. Rates of diuretic and digoxin prescriptions correlate strongly and are presumably both markers for similar cardiovascular morbidity. There was no evidence that ACE inhibitors modulated the rate of heart failure admissions.