Key result
Among outpatients with stable coronary artery disease in Latvia, 35.9% had an inadequately controlled resting heart rate of ≥70 bpm, highlighting unused potential for better risk factor management.
Cross-Sectional (n=120)
Yes
Despite high adherence to guideline-directed medical therapy in Latvian outpatients with stable CAD, there is significant under-dosing of beta-blockers leading to suboptimal heart rate control.
May signal beta-blocker under-dosing in stable CAD outpatients; leaves open whether titration improves outcomes.
Heart rate and other risk factors in outpatients with stable coronary artery disease in Latvia The aim of the study was to characterise coronary artery disease (CAD) outpatients in Latvia by risk factors (RF) including heart rate (HR), physical examination data, clinical data and treatment. Twelve practitioners had each examined and questioned 6 to 12 patients with established CAD (n = 120). The most frequent cardiovascular (CV) RF and co-morbidity were dyslipidemia (94.2%) and hypertension (78.3%), respectively. Prevalence of increased resting HR (≥70 bpm) was 35.9% and 33.6%, when measured by pulse palpation and electrocardiography, respectively. Regarding other RFs, prevalence of treated but insufficiently controlled blood pressure 140/90 mmHg, total cholesterol 1 > 5 mmol/l and triglycerides > 1.7 mmol/l was 25.8%, 30.1% and 33.3%, respectively. Aspirin, statins and angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers were used in 96.7%, 94.2% and 85.0% of cases, respectively. Beta blockers were used in 81.7% of cases. Average daily doses of most frequently used β blockers (metoprolol and bisoprolol) were 32% and 53% from target doses, respectively. In three cases β blockers were combined with ivabradin. Our results suggest that practitioners follow guidelines and consider CV prevention by treating CAD patients. Our data identified, however, unused potential for better control of increased HR by higher doses and combinations of HR-reducing agents.
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Balode et al. (2011) conducted a cross-sectional in Stable coronary artery disease (n=120). Resting heart rate and other cardiovascular risk factors was evaluated on Prevalence of increased resting heart rate (≥70 bpm) by pulse palpation. Among outpatients with stable coronary artery disease in Latvia, 35.9% had an inadequately controlled resting heart rate of ≥70 bpm, highlighting unused potential for better risk factor management.
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