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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
PubMed

Insights

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.
Abstract

Keywords:
ACE inhibitorsarteriopathic diseasebeta-blockersstatinsvascular disease

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