A Prospective Study on Cardiovascular Risk Factors- Control and Management in Patients with IHD at a Tertiary Hospital

Abstract

The aim of the study was to assess the management of two major risk factors (HTN and DM) in patients with pre-existing IHD by comparing the therapies of the patients with the standard guidelines as prescribed by AHA/ADA.11110 Categorized them into rational and irrational therapies. The prescriptions of 80 consecutive patients were reviewed with established IHD for GDMT of two major risk factors -HTN and DM, 40% of whom had more than 5 IHD risk factors. For Antihypertensive treatments, the overall rationality was 60% and 40% irrational. The majority of the irrationality for antihypertensives was observed among CAD (33.33%) and BBB (66.66%), with the former lacking the drug of choice (ACE/ARB) and the latter having a contraindicated Drug (Betablockers). Overall, 18% of the therapies used on 59 diabetic patients were rational, while 82 % were irrational. The most common non-compliance with the guidelines reported among antihyperglycemics was the lack of use of metformin as monotherapy 91% of the time. A significant finding of irrational antihyperglycemics was, the use of antihyperglycemics with neutral CV effects rather than those with possible cardio protection. The CHIS score demonstrated that the majority of the population (35%) fell under intermediate control, 33.75 % was in good control, and 31.25 % was in poor control group, The poor control group showed peak MVO2(1294) amongst the three groups, highlighting elevated myocardial oxygen demand as the control declined.