Awareness and use of cardiovascular risk scores by family physicians in southeastern Ontario

Murray F. Matangi, David W. J. Armstrong, Amer M. Johri, Ursula Jurt, Peter M. Hollett, Robert W. Del Grande, J. Paul DeYoung, Joel M. Niznick, Daniel D. Broiullard

Belleville General Hospital, Belleville, Canada.
Cornwall General Hospital, Cornwall, Canada.
Division of Cardiology, Kingston General Hospital and Queen’s University, Kingston, Canada.
Ottawa Cardiovascular Centre, Ottawa, Canada.
Perth & Smiths Falls District Hospital, Perth, Canada.
The Kingston Heart Clinic, Kingston, Canada.

DOI: 10.4236/ojpm.2013.38065                

Abstract

Background: Our objective was to determine the assessment of cardiovascular risk by family physicians. Methods: A questionnaire was sent by mail or fax regarding both awareness and use of the various CV risk scores in southeastern Ontario. Results: Of 181 family physicians surveyed, 96% were aware of at least one CV risk score and 40% were aware of the JUPITER study. Despite this awareness, 72% simply counted risk factors to assess risk, rather than to calculate risk using established scoring methods. Only 23% used the JUPITER study criteria. This suggests an under-estimated of overall CV risk by family physician’s practicing in southeastern Ontario. Interpetation: Cardiovascular risk in primary care is being underestimated in southeastern Ontario. Additional knowledge translation strategies are required to enhance the family physician’s awareness and use of established risk scoring methods if we are to reduce the burden of CV disease.

Keywords

Risk Assessment; Primary Prevention; Cardiovascular Disease

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Anderson, T.J., Grégoire, J., Hegele, R.A., Couture, P., Mancini, G.B., McPherson, R., Francis, G.A., Poirier, P., Lau, D.C., Grover, S., Genest, J., Jr., Carpentier, A.C., Dufour, R., Gupta, M., Ward, R., Leiter, L.A., Lonn, E., Ng, D.S., Pearson, G.J., Yates, G.M., Stone, J.A. and Ur, E. (2013) 2012 Update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Canadian Journal of Cardiology, 29, 151-157. http://dx.doi.org/10.1016/j.cjca.2012.11.032
[2]	Gupta, M., Singh, N., Tsigoulis, M., Kajil, M., Hirjikaka, S., Quan, A., Teoh, H. and Verma, S. (2012) Perceptions of Canadian Primary care physicians towards cardiovascular risk assessment and lipid management. Canadian Journal of Cardiology, 28, 14-19. http://dx.doi.org/10.1016/j.cjca.2011.09.014
[3]	Conroy, R.M., Pyörälä, K., Fitzgerald, A.P., Sans, S., Menotti, A., De Backer, G., De Bacquer, D., Ducimetière, P., Jousilahti, P., Keil, U., Njølstad, I., Oganov, R.G., Thomsen, T., Tunstall-Pedoe, H., Tverdal, A., Wedel, H., Whincup, P., Wilhelmsen, L. and Graham, I.M. (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. European Heart Journal, 24, 987-1003. http://dx.doi.org/10.1016/S0195-668X(03)00114-3
[4]	Ridker, P.M., Danielson, E., Fonseca, F.A., Genest, J., Gotto, A.M., Jr., Kastelein, J.J., Koenig, W., Libby, P., Lorenzatti, A.J., MacFadyen, J.G., Nordestgaard, B.G., Shepherd, J., Willerson, J.T. and Glynn, R.J. (2008) Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. The New England Journal of Medicine, 359, 2195. http://dx.doi.org/10.1056/NEJMoa0807646
[5]	Mosca, L., Barrett-Connor, E. and Wenger, N.K. (2011) Sex/Gender differences in cardiovascular disease prevention what a difference a decade makes. Circulation, 124, 2145-2154. http://dx.doi.org/10.1161/CIRCULATIONAHA.110.968792
[6]	Linton, M.R.F. and Fazio, S. (2003) A practical approach to risk assessment to prevent coronary artery disease and its complications. American Journal of Cardiology, 92, 19-26. http://dx.doi.org/10.1016/S0002-9149(03)00505-8
[7]	Armstrong, D.W.J., Brouillard, D. and Matangi, M.F. (2011) The effect of the change in the Framingham risk score calculator between the 2006 and 2009 Canadian lipid guidelines. Canadian Journal of Cardiology, 27, 167-170. http://dx.doi.org/10.1016/j.cjca.2010.12.025
[8]	Sachdeva, A., Cannon, C.P., Deedwania, P.C., Labresh, K.A., Smith, S.C., Jr., Dai, D., Hernandez, A. and Fonarow, G.C. (2009) Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines. American Heart Journal, 157, 111-117. http://dx.doi.org/10.1016/j.ahj.2008.08.010
[9]	Biro, S.C., Barber, D.T. and Kotecha, J.A. (2012) Trends in the use of electronic medical records. Canadian Family Physician, 58, e21.