Health Rep. pattern data from Canadian registries and published therapy effectiveness from medical trials. RESULTS: Among 2.2 million high-risk Canadians, current care and attention with statin, ASA and ACEI therapy has reduced the estimated occurrence of CV events over the next 10 years by approximately 400,000 from 1.01 million. Common use of combination statin, ASA and ACEI therapy for high-risk individuals, compared with current care, would prevent as many as 143,000 more CV events over the next 10 years. CONCLUSIONS: Great improvements in the management of CV disease have been made; however, CV disease remains a substantial burden to individuals and to the Canadian health care system. Canadian physicians have the opportunity to further reduce this burden through ideal management of high-risk individuals based on medical guidelines. strong class=”kwd-title” Keywords: ACE inhibitors, Acetylsalicylic acid, Canadian health care system, Death, Myocardial infarction, Stroke Rsum HISTORIQUE : Des preuves solides appuient lutilisation des statines, de lacide actylsalicylique (AAS) et des inhibiteurs de lenzyme de conversion de langiotensine (IECA) chez les individuals exposs un risque cardiovasculaire (CV) lev. Or, les donnes sur les modes de pratique actuels indiquent un important foss entre ces preuves et la pratique. OBJECTIFS : Quantifier la rduction des vnements CV quil est possible dobtenir avec une utilisation optimum des traitements vasculoprotecteurs chez les Canadiens exposs un risque lev de complications cardiovasculaires. MTHODES : Les donnes wheels de lEnqute sur la sant dans les collectivits canadiennes pour 2003 ont servi estimer la prvalence de la maladie cardiaque et/ou du diabte qui a t applique la human population spcifique lage au Canada afin de calculer le nombre total de individuals risque lev. Le nombre dvnements sur une priode de dix ans a t estim laide dun modle de transition dtat, dquations de risque publies, de donnes sur les modes de pratique provenant de registres canadiens et en tenant compte de lefficacit des traitements rvle par la publication dtudes cliniques. RSULTATS : Pour 2,2 thousands de Canadiens risque lev, le traitement actuel par statine, AAS et IECA a ramen loccurrence estime des vnements CV au cours des dix prochaines annes denviron Granisetron Hydrochloride 1,01 million 400 000. Lutilisation universelle dun traitement dassociation par statine, AAS et IECA chez les individuals risque lev, comparativement aux soins actuels, prviendra jusqu 143 000 complications CV de plus au cours des dix prochaines annes. CONCLUSION : La prise en charge de la maladie CV a fait de grands progrs. Par contre, la maladie continue de reprsenter un fardeau substantiel pour les patients et pour le systme de soins de sant canadiene. Les mdecins canadiens ont la possibilit dallger davantage ce fardeau en observant les directives cliniques pour la prise en charge optimum des patients risque lev. Canadian patients with cardiovascular disease (CVD) are at risk for significant morbidity and mortality related to CV events such as myocardial infarction and stroke. The magnitude of the health problem is substantial, with 419,000 hospitalizations and over 74,000 deaths annually due to disease of the circulatory system (1). Strong evidence exists to support the use of combination therapy with statins, acetylsalicylic acid (ASA) and angiotensin-converting enzyme inhibitors (ACEI) in patients with CVD and/or diabetes to reduce the risk of CV events. Evidence-based estimates have indicated that the use of all such therapies may result in substantial reduction in the risk associated with CVD (2,3). This evidence has been incorporated into multiple clinical practice guidelines and the importance of optimal treatment has been recognized as a part of good clinical practice (4C7). However, current practice patterns indicate a significant and ongoing care space in the management of patients with CVD by Canadian physicians (8C10). This care gap exists despite continuing medical education, which is now an integral part of physician licensing to practice. Thus, a call to action is needed with specific quantitative data to energize Canadian physicians toward optimal management of their high-risk patients. The objective of the present study was to quantify the reduction in CV events that may be obtained with the use of combination statin, ASA and ACEI therapy in Canadians over the age of 50 years who are at high Rabbit polyclonal to Hsp90 risk of.Finally, the number of events with optimal therapy was calculated by applying the RRR with triple therapy compared with no statin, ASA or ACEI therapy (see Step 4 4) with the calculated quantity of events with no statin, ASA or ACEI therapy. Sensitivity analyses A number of analyses were conducted to test the sensitivity of the results to the uncertainty in the model parameters. reduced the estimated occurrence of CV events over the next 10 years by approximately Granisetron Hydrochloride 400,000 from 1.01 million. Universal use of combination statin, ASA and ACEI therapy for high-risk patients, compared with current care, would prevent as many as 143,000 more CV events over the next 10 years. CONCLUSIONS: Great improvements in the management of CV disease have been made; however, CV disease remains a substantial burden to patients and to the Canadian health care system. Canadian physicians have the opportunity to further reduce this burden through optimal management of high-risk patients based on clinical guidelines. strong class=”kwd-title” Keywords: ACE inhibitors, Acetylsalicylic acid, Canadian health care system, Death, Myocardial infarction, Stroke Rsum HISTORIQUE : Des preuves solides appuient lutilisation des statines, de lacide actylsalicylique (AAS) et des inhibiteurs de lenzyme de conversion de langiotensine (IECA) chez les patients exposs un risque cardiovasculaire (CV) lev. Or, les donnes sur les modes de pratique actuels indiquent un important foss entre ces preuves et la pratique. OBJECTIFS : Quantifier la rduction des vnements CV quil est possible dobtenir avec une utilisation optimum des traitements vasculoprotecteurs chez les Canadiens exposs un risque lev de complications cardiovasculaires. MTHODES : Les donnes tires de lEnqute sur la sant dans les collectivits canadiennes pour 2003 ont servi estimer la prvalence de la maladie cardiaque et/ou du diabte qui a t applique la populace spcifique lage au Canada afin de calculer le nombre total de patients risque lev. Le nombre dvnements sur une priode de dix ans a t estim laide dun modle de transition dtat, dquations de risque publies, de donnes sur les modes de pratique provenant de registres canadiens et en tenant compte de lefficacit des traitements rvle par la publication dtudes cliniques. RSULTATS : Pour 2,2 hundreds of thousands de Canadiens risque lev, le traitement actuel par statine, AAS et IECA a ramen loccurrence estime des vnements CV au cours des dix prochaines annes denviron 1,01 million 400 000. Lutilisation universelle dun traitement dassociation par statine, AAS et IECA chez les patients risque lev, comparativement aux soins actuels, prviendra jusqu 143 000 complications CV de plus au cours des dix prochaines annes. CONCLUSION : La prise en charge Granisetron Hydrochloride de la maladie CV a fait de grands progrs. Par contre, la maladie continue de reprsenter un fardeau substantiel pour les patients et pour le systme de soins de sant canadiene. Les mdecins canadiens ont la possibilit dallger davantage ce fardeau en observant les directives cliniques pour la prise en charge optimum des patients risque lev. Canadian patients with cardiovascular disease (CVD) are at risk for significant morbidity and mortality related to CV events such as myocardial infarction and stroke. The magnitude of the health problem is substantial, with 419,000 hospitalizations and over 74,000 deaths annually due to disease of the circulatory system (1). Strong evidence exists to support the use of combination therapy with statins, acetylsalicylic acid (ASA) and angiotensin-converting enzyme inhibitors (ACEI) in patients with CVD and/or diabetes to reduce the risk of CV events. Evidence-based estimates have indicated that the use of all such therapies may result in substantial reduction in the risk associated with CVD (2,3). This evidence has been incorporated into multiple clinical practice guidelines and the importance of optimal treatment has been recognized as a part of good clinical practice (4C7). However, current practice patterns indicate a significant and ongoing care space in the management of patients with CVD by Canadian physicians (8C10). This care gap exists despite continuing medical education, which is now an integral part of physician licensing to practice. Thus, a call to action is needed with specific quantitative data to energize Canadian physicians toward optimal management of their high-risk patients. The objective of the present study was to quantify the reduction in CV events that may be obtained with the use of combination statin, ASA and ACEI therapy in Canadians over the age of 50 years who are at high risk of CV events. METHODS The present analysis used a state transition cohort model using Canadian populace data to predict the incidence of CV events based on patient risk factor profile and treatment. Patients enter the model at a given age and with a given profile of CV risk factors. Each year, a patient may experience a fatal or nonfatal stroke or myocardial infarction (MI), pass away of other causes or remain disease-free. Probabilities.