Are national cardiac guidelines being applied by vascular surgeons?

K Cassar, J. J. F. Belch, J Brittenden

    Research output: Contribution to journalArticle

    28 Citations (Scopus)

    Abstract

    Introduction. National cardiac guidelines recommend that patients with intermittent claudication should be managed in the same way as those with established coronary heart disease. This survey aimed to determine the attitudes of vascular consultants to risk factor management in new patients attending their out-patient clinic.

    Methods. An anonymous postal questionnaire was sent to all 394 members of the Vascular Surgical Society in June 2002. Questions were asked about the following measures: serum cholesterol levels, the presence of diabetes, antiplatelet therapy, exercise regimens, blood pressure, thrombophilia, smoking and the availability of local guidelines and expertise.

    Results. A response rate of 65% was obtained. Most (85%) consultants would measure a random cholesterol, but 34% would only treat claudicants if the cholesterol was greater than 5.5 mmol/l. Furthermore, 23% would inappropriately use diet alone as initial cholesterol lowering therapy. Over a quarter of consultants would not screen for diabetes or measure blood pressure. Nearly all (99%) would recommend aspirin and 66% would recommend nicotine replacement therapy. Only 55% had access to a smoking cessation clinic, and 34% to a formal exercise program. The majority (56%) did not have local risk factor management guidelines, only 16% had access to a vascular physician, and 65% would prefer to have this expertise available for difficult cases.

    Discussion. Management of major risk factors was found to be sub-optimal. Thus guidelines for the prevention of coronary disease in clinical practice are not being applied to claudicants.

    Original languageEnglish
    Pages (from-to)623-628
    Number of pages6
    JournalEuropean Journal of Vascular and Endovascular Surgery
    Volume26
    Issue number6
    DOIs
    Publication statusPublished - Dec 2003

    Fingerprint

    Blood Vessels
    Consultants
    Cholesterol
    Guidelines
    Risk Management
    Coronary Disease
    Blood Pressure
    Exercise Therapy
    Intermittent Claudication
    Thrombophilia
    Smoking Cessation
    Nicotine
    Aspirin
    Outpatients
    Smoking
    Exercise
    Diet
    Physicians
    Surgeons
    Therapeutics

    Cite this

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    title = "Are national cardiac guidelines being applied by vascular surgeons?",
    abstract = "Introduction. National cardiac guidelines recommend that patients with intermittent claudication should be managed in the same way as those with established coronary heart disease. This survey aimed to determine the attitudes of vascular consultants to risk factor management in new patients attending their out-patient clinic. Methods. An anonymous postal questionnaire was sent to all 394 members of the Vascular Surgical Society in June 2002. Questions were asked about the following measures: serum cholesterol levels, the presence of diabetes, antiplatelet therapy, exercise regimens, blood pressure, thrombophilia, smoking and the availability of local guidelines and expertise. Results. A response rate of 65{\%} was obtained. Most (85{\%}) consultants would measure a random cholesterol, but 34{\%} would only treat claudicants if the cholesterol was greater than 5.5 mmol/l. Furthermore, 23{\%} would inappropriately use diet alone as initial cholesterol lowering therapy. Over a quarter of consultants would not screen for diabetes or measure blood pressure. Nearly all (99{\%}) would recommend aspirin and 66{\%} would recommend nicotine replacement therapy. Only 55{\%} had access to a smoking cessation clinic, and 34{\%} to a formal exercise program. The majority (56{\%}) did not have local risk factor management guidelines, only 16{\%} had access to a vascular physician, and 65{\%} would prefer to have this expertise available for difficult cases. Discussion. Management of major risk factors was found to be sub-optimal. Thus guidelines for the prevention of coronary disease in clinical practice are not being applied to claudicants.",
    author = "K Cassar and Belch, {J. J. F.} and J Brittenden",
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    Are national cardiac guidelines being applied by vascular surgeons? / Cassar, K; Belch, J. J. F.; Brittenden, J.

    In: European Journal of Vascular and Endovascular Surgery, Vol. 26, No. 6, 12.2003, p. 623-628.

    Research output: Contribution to journalArticle

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    N2 - Introduction. National cardiac guidelines recommend that patients with intermittent claudication should be managed in the same way as those with established coronary heart disease. This survey aimed to determine the attitudes of vascular consultants to risk factor management in new patients attending their out-patient clinic. Methods. An anonymous postal questionnaire was sent to all 394 members of the Vascular Surgical Society in June 2002. Questions were asked about the following measures: serum cholesterol levels, the presence of diabetes, antiplatelet therapy, exercise regimens, blood pressure, thrombophilia, smoking and the availability of local guidelines and expertise. Results. A response rate of 65% was obtained. Most (85%) consultants would measure a random cholesterol, but 34% would only treat claudicants if the cholesterol was greater than 5.5 mmol/l. Furthermore, 23% would inappropriately use diet alone as initial cholesterol lowering therapy. Over a quarter of consultants would not screen for diabetes or measure blood pressure. Nearly all (99%) would recommend aspirin and 66% would recommend nicotine replacement therapy. Only 55% had access to a smoking cessation clinic, and 34% to a formal exercise program. The majority (56%) did not have local risk factor management guidelines, only 16% had access to a vascular physician, and 65% would prefer to have this expertise available for difficult cases. Discussion. Management of major risk factors was found to be sub-optimal. Thus guidelines for the prevention of coronary disease in clinical practice are not being applied to claudicants.

    AB - Introduction. National cardiac guidelines recommend that patients with intermittent claudication should be managed in the same way as those with established coronary heart disease. This survey aimed to determine the attitudes of vascular consultants to risk factor management in new patients attending their out-patient clinic. Methods. An anonymous postal questionnaire was sent to all 394 members of the Vascular Surgical Society in June 2002. Questions were asked about the following measures: serum cholesterol levels, the presence of diabetes, antiplatelet therapy, exercise regimens, blood pressure, thrombophilia, smoking and the availability of local guidelines and expertise. Results. A response rate of 65% was obtained. Most (85%) consultants would measure a random cholesterol, but 34% would only treat claudicants if the cholesterol was greater than 5.5 mmol/l. Furthermore, 23% would inappropriately use diet alone as initial cholesterol lowering therapy. Over a quarter of consultants would not screen for diabetes or measure blood pressure. Nearly all (99%) would recommend aspirin and 66% would recommend nicotine replacement therapy. Only 55% had access to a smoking cessation clinic, and 34% to a formal exercise program. The majority (56%) did not have local risk factor management guidelines, only 16% had access to a vascular physician, and 65% would prefer to have this expertise available for difficult cases. Discussion. Management of major risk factors was found to be sub-optimal. Thus guidelines for the prevention of coronary disease in clinical practice are not being applied to claudicants.

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