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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
Published on: December 11, 2013
Completing the audit cycle: comparison of cardiac risk factor management in patients with intermittent claudication
A M Wilson1, P Bachoo, I A Mackay
1Department of Vascular Surgery, NHS Grampian, United Kingdom.
Insights
Cardiac risk factor management for intermittent claudication (IC) shows suboptimal control, with diagnostic challenges in primary care. Improvements in statin use were noted, but blood pressure and physical activity advice remain inadequate.
Area of Science:
- Vascular Medicine
- Cardiology
- Public Health
Background:
- Intermittent claudication (IC) management prioritizes life extension through cardiac risk factor control.
- Previous audits highlighted areas for improvement in secondary prevention for IC patients.
Purpose of the Study:
- To compare current secondary prevention strategies for IC with historical data.
- To assess the effectiveness of cardiac risk factor management in a contemporary IC patient cohort.
Main Methods:
- Prospective data collection on 304 new intermittent claudication referrals (2004/2005).
- Comparison of risk factor data with a previous audit of 104 patients (2000).
Main Results:
- 30% of patients lacked confirmed IC diagnosis.
- Statin therapy increased significantly (62% vs 38%), but blood pressure control remained poor (65% above target).
- Antiplatelet use was static (73%), smoking cessation offered to few, and advice on physical activity decreased (15% to 2%). Undiagnosed diabetes found in 17%.
Conclusions:
- Diagnosing intermittent claudication in primary care presents challenges.
- Cardiac risk factor management for IC patients remains suboptimal, necessitating improved clinical interventions.
Aim:
The first line treatment of patients with intermittent claudication (IC) is to prolong life via cardiac risk factor management. We aimed to compare current standards of secondary prevention with those in a previously published audit.
Methods:
Risk factor data was prospectively collated on 304 consecutive new referrals attending the claudication clinic over a 1-year period (2004/2005) and compared to the 104 patients assessed in 2000.
Results:
In 2004/5 30%, (n=91) of patients did not have a diagnosis of IC confirmed (p<0.01). The use of antiplatelet therapy remained static at 73%. Statin therapy increased in 2004/5 (62% versus 38%, p<0.01) but blood pressure control remained poor with 65% failing to achieve the target levels. Smoking cessation therapy continues to be offered to a minority of patients and 17% of patients have previously undiagnosed diabetes in 2004/2005 (p-value 0.353). The number of patients who have been advised to increase physical activity significantly has fallen from 15% to 2% in the 2004/5 (p<0.01).
Conclusions:
Difficulties exist in diagnosing intermittent claudication in primary care and cardiac risk factor management continues to be sub-optimally managed.
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