Risk Factor Modification for Vascular Disease in North Carolina Prisons

Area of Science:

• Vascular Surgery
• Cardiology
• Public Health
• Health Policy

Background:

• The healthcare needs of the US incarcerated population are increasing, necessitating effective management within correctional facilities.
• Adherence to cardiovascular risk factor management guidelines in this population is not well-documented.

Purpose of the Study:

• To evaluate adherence to prescribing guidelines for vascular risk factors in incarcerated patients referred for vascular surgery evaluation.
• To identify gaps in the management of hypertension, diabetes, hyperlipidemia, and atherosclerotic disease in this specific patient group.

Main Methods:

• Retrospective review of medical records for 57 incarcerated patients with noncoronary atherosclerotic disease.
• Data collected between 2019 and 2023 in North Carolina.
• Analysis of prescribing patterns for antiplatelet agents, statins, antihypertensives, and antihyperglycemics.

Main Results:

• At referral, 66.6% received antiplatelet agents, 61.4% received statins, and 49.1% received both.
• 82.5% had hypertension, with 87.2% prescribed antihypertensives.
• 50.8% had diabetes, with 72.4% prescribed antihyperglycemics.
• 43.9% had hyperlipidemia, with 84.0% prescribed lipid-lowering medication.

Conclusions:

• Treatment for hypertension and diabetes in this incarcerated cohort was largely guideline-concordant.
• Significant gaps were identified in the appropriate prescribing of statins and antiplatelet agents for vascular risk reduction.
• Improved adherence to guidelines for lipid-lowering and antiplatelet therapy is needed for incarcerated patients with atherosclerotic disease.