[ACEI/ARB use among high risk patients with coronary heart disease in China: a cross-sectional study].
Liu J-M., Ge L., Li J., Li X., Feng F., Zhang H-B., Gao Y., Wuhan B-L-G., Pang X., Chen Y-P., Chen Z-M., Landray M., Armitage J., Chen F., Jiang L-X., HPS2-THRIVE China collaborative group None.
OBJECTIVE: This study investigated current use of ACEI/ARB among high risk patients with coronary heart disease (CHD) in China and factors affecting ACEI/ARB use in these patients. METHODS: This cross-sectional survey was performed between June to December 2007 and May to November 2009 in 51 hospitals from 14 cities. The characteristics of patients with established CHD were collected by electronic questionnaire. RESULTS: Only 45.8% high risk CHD patients were taking ACEI/ARB and the ACEI/ARB medication decreased significantly with time after initial CHD diagnosis. ACEI/ARB was taken in 46.1% CHD patients complicated with diabetes mellitus and in 56.3% CHD patients complicated with hypertension. Logistic regression analysis showed that comorbid hypertension was the strongest factor associated with ACEI/ARB use. In addition, male gender, history of myocardial infarction (MI), PCI and the time after initial CHD diagnosis were independent factors affecting the use of ACEI/ARB. Captopril was the most commonly prescribed ACEI in this cohort. CONCLUSION: ACEI/ARB is underused in secondary prevention among high risk CHD patients in China. It remains a major challenge for healthcare professionals and policy makers to make efforts on narrowing the gap between evidence and practice.