Document Detail


Cardioprotective medication use in hemodialysis patients.
MedLine Citation:
PMID:  16835669     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiovascular disease is the leading cause of mortality in patients with renal failure, accounting for more than 50% of deaths in end-stage renal disease. Risk factor modification with the use of cardioprotective medications such as angiotensin-converting enzyme inhibitors (ACEIs), beta-adrenergic antagonists (beta-blockers), acetylsalicylic acid (ASA) and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) has been shown to reduce mortality in the general population.
OBJECTIVE: To determine the extent of use of these medications in a hemodialysis population.
METHODS: This was a cross-sectional study of a cohort of 185 prevalent hemodialysis patients. The inclusion criterion was dialysis dependence and there were no exclusion criteria. Data collection was by chart review. Contraindications to individual medication classes were not obtained.
RESULTS: There were 185 patients enrolled, the mean age was 63.42+/-15.1 years and 126 (68.1%) were male. Sixty-six (35.7%) patients had diabetes and 89 (48.1%) patients had established coronary artery disease (CAD). Forty-six (24.9%) patients were on ACEIs or angiotensin II receptor blockers, 59 (31.9%) were on beta-blockers, 70 (37.8%) were on ASA and 84 (45.4%) were on statins. Although these medications were used in fewer than 60% of patients, those with CAD were more likely to be prescribed an ACEI or an angiotensin II receptor blocker (P=0.026), a beta-blocker (P<0.001), ASA (P<0.001) or a statin (P=0.001) than those without CAD. There were no differences in the use of these medications between diabetic and nondiabetic patients.
CONCLUSIONS: Many hemodialysis patients are not prescribed cardioprotective medications. Given the high cardiovascular mortality in this high-risk population, more attention to reducing cardiovascular risk is warranted.
Authors:
Lisa M Miller; Wilma M Hopman; Jocelyn S Garland; Karen E Yeates; Rachel M Pilkey
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  22     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-12     Completed Date:  2006-08-29     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  755-60     Citation Subset:  IM    
Affiliation:
Section of Nephrology, University of Manitoba, Winnipeg, Canada. lmiller@exchange.hsc.mb.ca
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MeSH Terms
Descriptor/Qualifier:
Cardiotonic Agents / therapeutic use*
Cardiovascular Diseases / complications,  mortality,  prevention & control*
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic / complications,  therapy*
Male
Middle Aged
Ontario / epidemiology
Renal Dialysis*
Retrospective Studies
Survival Rate
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiotonic Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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