IMPLICATION OF PRESCRIPTIONS FOR NITRATES - 7 YEAR FOLLOW-UP OF PATIENTS TREATED FOR ANGINA IN GENERAL-PRACTICE

Objective-To determine the demand placed on local cardiological servic es by patients prescribed nitrates for ischaemic heart disease. Design -A follow up study of a cohort of patients identified in 1985. Setting -Nottingham Health District. Patients-Four hundred and ninety nine pat ients prescribed nitrates in 1985 for presumed ischaemic heart disease . Main outcome measures-Referral to medical outpatients, admittance to hospital with chest pain, cardiological investigations, and mortality . Results-Over the seven year period 26% of patients were admitted urg ently with chest pain and 15% were referred to the medical outpatient department-a referral rate of 6% a year. 4% of patients had an exercis e test and 6% a coronary angiogram. The death rate was 6% a year and a higher proportion died of cardiovascular causes than would be expecte d in the general population. Conclusions-Prescription of nitrate is us eful in the determination of the prevalence of ischaemic heart disease . Most patients with angina are still treated within the community, an d the rate of specialist investigation remains low.