Objective: To analyze the status of beta blockers (BBs) prescription in Chinese patients with stable angina pectoris. To determine the gap between clinical practice and treatment guidelines and factors influencing the use of BBs in Chinese patients.
Method: A questionnaire survey was conducted in patients diagnosed with chronic stable angina pectoris in 2011. A total of 298 Chinese hospitals attended the survey. The questionnaire collected patient demographic information, clinical and medication information. In the analysis, patients were divided into two groups according to whether they were on BBs at the time of the interview. Hospital characteristics, patient demographic information, cardiovascular risk factors, diagnostic method of coronary heart disease, past history of coronary revascularization and use of secondary prevention medications were compared between the two groups. Binary logistic regression analysis was used to identify factors related to BBs use. Patients were followed-up for 3 months. Patients who were on BBs at baseline were divided into two groups according to whether they were still on BBs after 3 months. Comparison of the clinical information previously mentioned was made between the two groups, and binary logistic regression analysis was used to identify factors related to BBs adherence.
Results: Of the 5 011 questionnaires, 2 859 cases were male, mean age was (67.6 ± 11.5) years old, 3 060 (61.1%) patients were on BBs at baseline. Binary logistic regression analysis showed that when adjusted for other factors, old age (OR = 0.895, 95% CI 0.849-0.944, P<0.001) was related to no BBs use, while comorbidity with hypertension (OR = 1.255, 95% CI 1.103-1.427, P = 0.001) or hyperlipidemia (OR = 1.456, 95% CI 1.287-1.648, P<0.001), diagnosed with coronary disease by imaging (OR = 1.250, 95% CI 1.070-1.461, P = 0.005) and past history of coronary revascularization (OR = 1.490, 95% CI 1.220-1.820, P<0.001) were related to higher percentage of BBs use. A total of 2 533 cases (82.8%) were still taking BBs 3 months after baseline interview. Binary logistic regression analysis showed that, when adjusted for other factors, treated at traditional Chinese medical hospitals (OR = 1.612, 95% CI 1.154-2.251, P = 0.005), low levels of education (OR = 1.316, 95% CI 1.151-1.504, P<0.001), hypertension (OR = 1.345, 95% CI 1.096-1.651, P = 0.005), high baseline heart rate (OR = 1.020, 95% CI 1.010-1.030, P<0.001) and diagnosed with coronary disease by imaging (OR = 1.342, 95% CI 1.095-1.644, P = 0.005) were factors related to higher BBs adherence, while low baseline CCS class (OR = 0.794, 95% CI 0.704-0.896, P<0.001) was related to lower BBs adherence.
Conclusions: In Chinese patients with clinically diagnosed chronic stable angina, BBs use was not sufficient. Old age, comorbidity with hypertension or hyperlipidemia, past history of coronary revascularization were independently related to higher percentage of BBs use. Treated at traditional Chinese medical hospitals, low levels of education, hypertension, high baseline heart rate and diagnosed with coronary disease by imaging were independent factors related to higher BBs adherence, while low baseline CCS class was related to lower adherence.