Abstract:
AIM: To measure trends in the cardiovascular preventive medication prescribing in New Zealand primary care during 2000-2003. METHODS: Demographic, risk factor, and prescribing data from the Dunedin Royal New Zealand College of General Practitioners Research Unit database were analysed. The data set consisted of men aged at least 45 years and women at least 55 years, who consulted a doctor in 2000-2003 in a practice that supplied electronic clinical notes (total number varied by year from 24,292 to 30,842). RESULTS: Cardiovascular risk (as calculated by the Framingham-based [Anderson] risk equation) could only be estimated for one-third of the study population due to missing risk factor information. In 2000, prescription of both blood pressure- and cholesterol-lowering medications occurred in 28% of people with established vascular disease and 14-16% of people without vascular disease but with a 5-year cardiovascular risk over 5%. From 2000 to 2003, the treatment of all patient groups with a 5-year cardiovascular risk of >10% (vascular history or not) increased by about 4% per year. Those in the 5-10% cardiovascular risk bracket increased treatment by about 3% per year. CONCLUSIONS: Cardiovascular medicine treatment gaps in primary care reduced between 2000 and 2003 but a significant gap persisted. There is only modest evidence that treatment rates are targeted to estimated cardiovascular risk. Data on the prescription of these medications by cardiovascular risk needs to be collected, analysed, and disseminated on an ongoing basis to enable close monitoring of strategies to improve cardiovascular risk assessment and management.