Management of patients with suspected angina, but without known myocardial infarction: A cross-sectional survey

BACKGROUND: Although several studies describing the diagnostic and therapeutic management of patients with myocardial infarction (MI) by general practitioners have recently been published, little information exists about patients with angina without MI. AIM: To describe the management of patients with angina without known MI in general practice. DESIGN: A cross-sectional survey. SETTING: Italian general practitioners providing data to the Health Search Database. METHOD: Prevalent cases of angina, using the prescription of nitrates as a 'proxy' for disease status, in patients without known MI were selected from the Health Search Database. Data on patient demographics, clinical information, established therapies and cardiology visits were collected. A binomial logistic regression analysis was performed to test which variable made prescription more or less likely. RESULTS: There were 10 455 patients with angina. Blood pressure readings were available for 73.8% of patients; in this group 58.9% had inadequate (> or = 140/90 mmHg) blood pressure control. Total cholesterol was recorded in 61.6% of cases (mean value = 5.5 mmol/L). Antiplatelet or oral anticoagulant agents were used by 67.8% of the patients, while 24.1% of patients received lipid-lowering agents, 61% received ACE-inhibitors or angiotensin-II receptor antagonists, and 25.2% received beta-blockers. CONCLUSIONS: In patients treated with nitrates the monitoring of modifiable risk factors and the use of preventive drugs is lower than expected. New strategies aimed at improving secondary cardiovascular prevention among these easily identifiable high-risk subjects are needed.