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ACE up the sleeve - are vascular patients medically optimized?
A P Coveney1, G C O'Brien, G J Fulton
1Department of Vascular Surgery, Cork University Hospital, National University of Ireland, Cork, Ireland. acoveney@gmail.com
Vascular Health and Risk Management
|February 23, 2011
Summary
Arteriopathic patients often receive antiplatelets and statins, but angiotensin-converting enzyme (ACE) inhibitors and beta-blockers are under-prescribed. Vascular surgeons can improve medical management by enhancing collaboration and taking greater responsibility for patient care.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Pharmacology
Background:
- Arteriopathic patients require comprehensive medical management.
- Optimal medical therapy is crucial for improving outcomes in patients with arterial disease.
- Patients with vascular conditions are often managed by multiple medical specialties.
Purpose of the Study:
- To assess the current medical management of arteriopathic patients in a vascular surgical service.
- To evaluate the prescription rates of key cardiovascular medications, including antiplatelets, statins, ACE inhibitors, ARBs, and beta-blockers.
- To determine the influence of different medical specialties on medication prescribing patterns.
Main Methods:
- A 6-month prospective study of sequential patients attending a university teaching hospital's vascular surgical service.
- Data collection included patient demographics, arterial disease type, recent medical consultations, and current medications.
- Specific focus on the use of antiplatelets, statins, ACE inhibitors (or ARBs), and beta-blockers.
Main Results:
- 180 arteriopathic patients (mean age 69) were included.
- Nearly all patients (96%) received antiplatelets, predominantly aspirin.
- High statin use (86%), but lower rates for beta-blockers (44%) and ACE inhibitors (51%).
- Suboptimal prescription of ACE inhibitors and beta-blockers was observed irrespective of specialty consultations.
Conclusions:
- While antiplatelet and statin use aligns with evidence, ACE inhibitors and beta-blockers are under-prescribed in this population.
- Vascular surgeons have an opportunity to improve medical care by adhering to guidelines.
- Enhanced collaboration with primary care or increased surgeon responsibility for medical management is recommended.
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