Primary care research and clinical practice: cardiovascular disease

Improvement in survival of patients with cardiovascular diseases and an ageing population mean that management of cardiovascular conditions remains an important challenge for primary care. Traditionally cardiovascular research has been based largely in secondary or tertiary care settings. The majority of care for people with cardiovascular diseases, however, takes place in the community and within primary care. In recent years, progress has been made in conducting cardiovascular research within primary care itself. A number of different methodologies including large prospective cohort studies, randomised controlled trials, and qualitative designs have been used to inform optimal cardiovascular disease management for those in the community. Some of the recent research evidence in primary care in three areas of cardiovascular medicine--atrial fibrillation, heart failure, and cardiovascular risk prediction and management--are discussed in this review. These seek to demonstrate the contribution made by primary care research to the management of cardiovascular diseases.