Issue 19, May 2010
3. Rising heart attacks: Physician's ignorance or negligence?

     New study shows that, if doctors follow existing guidelines on cholesterol-lowering targets, they can prevent a greater number of heart attacks, strokes and deaths.

     In the guidance of Professor Heribert Schunkert the team selected 25,250 patients including 55 percent of male patients and 49 percent of female patients. The researchers also included 907 doctors to assess the way they are treating their patients' risk factors when assigning cholesterol-lowering targets. The results showed primary care physicians were more likely to underestimate women's risk. As an example, it was observed that in patients with an identical history and with a recent heart attack, only 60 percent of women were given correct treatment targets for reducing LDL levels compared to 68 percent of men.

     "In our study we observed an average difference in LDL target levels of just over 17 mg/dL between physicians with the least and best guideline knowledge, and this difference will certainly lead to a sizeable difference in major heart-related problems," said lead author of the study.

     "We hope that the data from our study will remind physicians of the need to observe relevant guidelines to calculate individually every patient's target value, so that they can deliver the best possible care to all their patients," said Schunkert.

     Schunkert is of the opinion that physicians should be assisted with simpler guidelines as well as analysing software and instruments to easily assess the patients' risk profile. Also he suggested that special care need to be given to women and patients of no known cardiovascular disease, but with accumulated risk factors, since they fail frequently to attract physician's notice in aggressive cholesterol-lowering treatment.

Source: Genest J; Canadian Journal of Cardiology 26 Suppl A 41A-44A (Mar 2010)
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