Discordance Between Physicians' Estimation of Patient Cardiovascular Risk and Use of Evidence-Based Medical Therapy Journal Articles uri icon

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  • Despite clinical trial evidence supporting the use of antiplatelets, angiotensin-converting enzyme inhibitors, and statins for cardiovascular risk reduction in high-risk patients, use of such therapies in real-world outpatients in the prospective Vascular Protection Registry and the Guidelines Oriented Approach to Lipid Lowering Registry was suboptimal (78%, 55%, and 75%, respectively). The most frequent reason physicians cited for nonprescription of statins (33%) was that patients were not high risk enough and/or current guidelines did not support statin use. In conclusion, outpatients at high cardiovascular risk continue to be undertreated as a result of a combination of physician underestimation of cardiovascular risk (knowledge gap) and barriers to implementation of evidence-based therapy (practice gap).


  • Tsang, Jennifer
  • Mendelsohn, Aurora
  • Tan, Mary KK
  • Hackam, Daniel G
  • Leiter, Lawrence A
  • Fitchett, David
  • Lin, Peter J
  • Grima, Etienne
  • Langer, Anatoly
  • Goodman, Shaun G

publication date

  • November 2008

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