Differences in generalists' and cardiologists' perceptions of cardiovascular risk and the outcomes of preventive therapy in cardiovascular disease

Article Abstract:

Many primary care doctors and heart specialists may overestimate the risk for heart complications and the value of preventive treatment in at-risk patients. Researchers asked 77 general internists, 84 family doctors, and 66 heart specialists to assess the 5-year risk for heart attack and the 3-year risk for stroke with and without preventive treatment in a set of hypothetical at-risk patients. These hypothetical patients had either elevated cholesterol levels, angina and blood vessel narrowing, or high blood pressure. More general internists (27%) and family doctors (30%) significantly overestimated by 10-fold the benefits of medication to prevent heart attacks in patients with high cholesterol levels as compared to the heart specialists making similar overestimates (10%). Heart specialists and primary care doctors gave equally accurate predictions of the survival rates and chose equally appropriate medications in patients with narrowed blood vessels. Twice as many heart specialists as primary care doctors suggested appropriate surgical intervention in these patients.

Methods, Beliefs, opinions and attitudes, Cardiologists, Preventive medicine, Physicians (General practice), General practitioners, Medicine, Preventive

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Assessment of cardiovascular risk: a return to basics

Article Abstract:

An initial evaluation by a physician may identify patients with a higher risk of significant coronary heart disease. This type of evaluation includes taking the patient's medical history, a physical examination and a series of simple laboratory tests. Many cardiologists and cardiovascular surgeons advocate the use of different invasive procedures to treat coronary heart disease regardless of the characteristics of the individual patient. The development and progression of coronary heart disease varies widely and is influenced by many different factors. A research study found that the progression of coronary heart disease in different patients could be predicted from an initial evaluation by a physician. All the patients had been referred by a physician for exercise testing for suspected coronary heart disease. The identification of patients with a higher risk of serious coronary heart disease may also help reduce the costs associated with treatment.

Editorial, Coronary heart disease

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Associations between smoking and newer risk factors for cardiovascular disease

Article Abstract:

Smokers are more likely than non-smokers to have elevated blood levels of fibrinogen, C-reactive protein, and homocysteine, according to a study of 17,353 people. Elevated blood levels of these three substances are believed to be risk factors for cardiovascular disease. This could explain why smoking increases a person's risk of cardiovascular disease.

Physiological aspects, Smoking, C-reactive protein, Fibrinogen, Homocysteine

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