Language:

Evidence of suboptimal management of cardiovascular risk in patients with type 2 diabetes mellitus and symptomatic atherosclerosis

Canadian Medical Association journal, 2004-11, Vol.171 (10), p.1189-1192 [Peer Reviewed Journal]

COPYRIGHT 2004 CMA Impact Inc. ;Copyright Canadian Medical Association Nov 9, 2004 ;2004 Canadian Medical Association or its licensors ;ISSN: 0008-4409 ;ISSN: 0820-3946 ;EISSN: 1488-2329 ;DOI: 10.1503/cmaj.1031965 ;PMID: 15534311 ;CODEN: CMAJAX

Full text available

Citations Cited by

Actions
1. Add to My Research
2. Remove from My Research
3. E-mail
4. Print
5. Permalink
6. Citation
7. EasyBib
8. EndNote
9. RefWorks
10. Delicious
11. Export RIS
12. Export BibTeX

Title:
Evidence of suboptimal management of cardiovascular risk in patients with type 2 diabetes mellitus and symptomatic atherosclerosis
Author: Brown, Lauren C ; Johnson, Jeffrey A ; Majumdar, Sumit R ; Tsuyuki, Ross T ; McAlister, Finlay A
Subjects: Adult ; Aged ; Aged, 80 and over ; Analysis ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Arteriosclerosis - drug therapy ; Arteriosclerosis - etiology ; Arteriosclerosis - prevention & control ; Atherosclerosis ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - prevention & control ; Care and treatment ; Cohort Studies ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes therapy ; Female ; Guideline Adherence ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Influence ; Male ; Middle Aged ; Platelet Aggregation Inhibitors - therapeutic use ; Practice Patterns, Physicians' - statistics & numerical data ; Risk factors ; Saskatchewan
Is Part Of: Canadian Medical Association journal, 2004-11, Vol.171 (10), p.1189-1192
Description: Given that most deaths among patients with diabetes mellitus are due to cardiovascular disease, we sought to determine the extent to which medications proven to reduce cardiovascular mortality are prescribed for patients with type 2 diabetes who have symptomatic atherosclerosis (i.e., coronary artery disease [CAD], cerebrovascular disease [CBVD] or peripheral arterial disease [PAD]). Administrative records from Saskatchewan Health were used to evaluate the use of antiplatelet agents, statins and angiotensin-converting enzyme (ACE) inhibitors by people with treated type 2 diabetes with and without symptomatic atherosclerosis. CAD and CBVD were defined by International Classification of Diseases (ninth revision) codes, and PAD was defined on the basis of pentoxifylline use or lower limb amputation. Multivariate logistic regression analysis was used to compare medication use in patients with and without PAD, with adjustments for differences in age, sex and comorbidity. In this cohort of 12,106 patients with type 2 diabetes (mean age 64 years, 55% male, mean follow-up 5 years), fewer than 25% received an antiplatelet agent or statin, and fewer than 50% received an ACE inhibitor. Although patients with CAD were more likely to receive antiplatelet agents, statins or ACE inhibitors than people without CAD (p < 0.001 for all), the overall use of these medications was suboptimal (37%, 29% and 60% respectively among patients with symptomatic CAD). Similar patterns of practice were found for patients with symptomatic CBVD and PAD. All 3 proven efficacious therapies were prescribed for only 11% of patients with CAD, 22% with CBVD and 12% with PAD. Patients with PAD who had undergone lower limb amputation were no more likely to subsequently receive antiplatelet agents or statins than those without an amputation. Diabetic patients with symptomatic atherosclerotic disease are undertreated with medications known to reduce cardiovascular morbidity and mortality, perhaps because of a "glucocentric" view of diabetes. Programs to improve the quality of cardiovascular risk reduction in these high-risk patients are needed.
Publisher: Canada: Can Med Assoc
Language: English
Identifier: ISSN: 0008-4409
ISSN: 0820-3946
EISSN: 1488-2329
DOI: 10.1503/cmaj.1031965
PMID: 15534311
CODEN: CMAJAX
Source: ProQuest One Psychology
GFMER Free Medical Journals
MEDLINE
PubMed Central
Alma/SFX Local Collection
ProQuest Central
DOAJ Directory of Open Access Journals

Back to results list

Previous Result 16 Next Go to Next page


INSPIRE LIBRARY - TON DUC THANG UNIVERSITY	(84-028) 37 755 057	Feedback
19 Nguyen Huu Tho St. Dist.7, HCM	thuvien@tdtu.edu.vn	Feedback

Evidence of suboptimal management of cardiovascular risk in patients with type 2 diabetes mellitus and symptomatic atherosclerosis

COPYRIGHT 2004 CMA Impact Inc. ;Copyright Canadian Medical Association Nov 9, 2004 ;2004 Canadian Medical Association or its licensors ;ISSN: 0008-4409 ;ISSN: 0820-3946 ;EISSN: 1488-2329 ;DOI: 10.1503/cmaj.1031965 ;PMID: 15534311 ;CODEN: CMAJAX

Searching Remote Databases, Please Wait