The ACE inhibitor cilazapril will soon be delisted – new alternatives include ramipril capsules and an 8mg perindopril tablet.
This article summarises recent and upcoming changes to ACE inhibitor availability, and provides a dose equivalence table and advice for switching between medicines.
The antihypertensive medicine Accuretic (quinapril with hydrochlorothiazide) is being withdrawn (Pfizer pulled stock from distribution on 31 October 2022).
Prescribers are advised to change patients from Accuretic to alternative medicine(s) with some urgency. Read our article for dose equivalence tables and information on switching, monitoring, co-payments and consultation fees.
Although triple therapy can reduce the risk of recurrent CVD events by at least 50 per cent over five years, the He Ako Hiringa EPiC dashboard indicates only half of people receive all three types of medicines following a CVD event. Read our latest bulletin for more on triple therapy and team-based initiatives that may help identify and prioritise patients for intensive management.
This editable PDF helps you to delve into the EPiC data, contemplate your prescribing, reflect on your current practice, and set goals and actions.
*New audit section*
An additional audit/CQI section allows you or your practice team to repeat the process, completing activities that may be used for Foundation Standard or the Cornerstone CQI or Equity modules.
This workbook consists of introductory reading and five distinct modules that encourage you to reflect on your CVD risk assessment and management practices, risk communication, cultural safety, and your engagement with young adult Māori and Pacific patients.
The current primary care CVD management guidance strongly recommends aggressive risk management and lifestyle modification in patients with pre-existing CVD or an equivalent CVD risk. Opportunities to improve use of CVD medicines remain, particularly for Māori and Pacific peoples who lose 2.6–2.8 times more years to CVD events relative to non-Māori/non-Pacific peoples.
In this article, Dr Jim Vause contemplates managing CVD risk, reasons for non-adherence, inequities in CVD treatment, and how to improve communication with patients.
Cardiovascular disease is the leading cause of death in New Zealand, accounting for 35 per cent of mortality in 2019. Yet it’s preventable and treatable. Māori, Pacific, and South Asian peoples have a disproportionately higher CVD risk compared with people not of these ethnicities. Therefore, CVD risk assessments in these ethnicities should begin earlier.
Rosuvastatin is now fully funded on Special Authority for people at increased risk of cardiovascular complications due to high cholesterol, and may be considered first-line for Māori and Pacific peoples.
An abridged version of this article, containing the eligibility flowchart, is available for printing - see the link in the contents box.