Table 3.
Physician-reported Knowledge and Attitudes Regarding Cardiovascular Disease Risk Factor Reduction by Patient Disease Status (N = 1,314)*
| Physicians' Knowledge and Attitudes | CAD (n = 442) | PAD (n = 438) | No Disease (n = 434) | Overall P Value |
|---|---|---|---|---|
| Percentage of physicians reporting that the following interventions have a “large effect” on the risk of future cardiovascular events | ||||
| Antiplatelet therapy | 41.8 | 28.8†,‡ | 19.4 | <.001 |
| Aerobic exercise | 23.0 | 22.7 | 25.0 | .667 |
| Supervised exercise program | 10.1 | 11.9 | 11.4 | .681 |
| Smoking cessation | 79.7 | 80.8 | 76.9 | .330 |
| Cholesterol lowering | 57.9 | 50.9 | 48.3 | .014 |
| Percentage of physicians who report that it is “extremely important” to | ||||
| Prescribe antiplatelet therapy | 61.5 | 37.8†,‡ | 22.7 | <.001 |
| Recommend aerobic exercise | 43.7 | 34.6 | 36.7 | .014 |
| Prescribe a supervised exercise program | 8.0 | 7.4 | 5.4 | .288 |
| Advise smoking cessation if the patient smokes | 95.5 | 93.2 | 92.4 | .147 |
| Recommend a cholesterol-lowering diet | 61.4 | 58.0 | 49.0 | <.001 |
| Prescribe cholesterol-lowering medication if the LDL cholesterol is increased despite nonpharmacologic therapy | 75.5 | 62.8†,‡ | 52.4 | <.001 |
| Physician-reported | ||||
| Ideal LDL level, mg/dL ±SD | 103.4 ± 13.9 | 106.9*,†± 18.4 | 119.1 ± 20.5 | <.001 |
| Percentage of physicians “completely familiar” with the following NCEP guidelines | ||||
| Average LDL level (mg/dL) at which cholesterol-lowering diet is prescribed | 38.6 | 32.3 | 33.7 | .121 |
| Average LDL level (mg/dL) at which cholesterol-lowering drug is prescribed | 42.1 | 34.7† | 34.7 | .033 |
| Physicians' estimates of cardiovascular event risk, % | ||||
| Average 5-year risk of cardiovascular events | 39.4 | 49.0†,‡ | 27.1 | <.001 |
Physicians were randomized to receive 1 of 3 survey types describing a hypothetical 55- to 65-year-old patient with: a) coronary artery disease, b) peripheral arterial disease, c) no clinically evident atherosclerosis, respectively. Surveys were identical except for the hypothetical patient presented in each of the 3 surveys. Half of the hypothetical patients were women and half were men.
Comparisons between PAD and CAD are statistically significant (P < .005 in χ2 test or analysis of variance with Bonferroni adjustment).
Comparisons between PAD and no-disease patients are statistically significant (P < .005 in χ2 test or analysis of variance with Bonferroni adjustment).
PAD, peripheral arterial disease; CAD, coronary artery disease; no disease, no clinically evident atherosclerosis; NCEP, National Cholesterol Education Program. Surgeons were excluded from these analyses because they received only the PAD survey.