Prescribing of ACE inhibitors for cardiovascular disorders in general practice

Objective: To investigate the prescribing patterns for angiotensin converting enzyme (ACE) inhibitors in the management of patients with heart failure and other cardiovascular disorders as part of a local project on heart failure using information collected from a Primary Care Information Initiative

Method: Patients from a large city-centre practice, who were receiving an ACE inhibitor or with a diagnosis of heart failure at the time of the study, were identified from medical records. Details of concomitant medical conditions and drug treatment were also recorded

Results: There was extensive prescribing of ACE inhibitors alone, in the treatment of patients with hypertension, where no contraindications for the use of thiazide diuretics or beta-blockers could be identified. ACE inhibitors were being prescribed for post-myocardial infarction patients, but the time for the initiation of treatment was rarely within that recommended in the literature. For those patients diagnosed with heart failure, 60% were not being treated with ACE inhibitors even where there were no contraindications

Conclusion: It is clear from the results of this study that overall prescribing patterns for ACE inhibitors are not always in accord with evidence from the literature. These findings provide valuable information for the initiation and development of clinical guidelines for prescribers