Prescribing and emergency admissions for heart failure in Greater Glasgow

Background: We sought to determine whether there is an association between the rate of prescription of angiotensin-converting enzyme (ACE) inhibitors and the rate of hospitalization for heart failure. Methods and Results: We conducted a cross-sectional study linking prescribi ng data with hospital admission data from 215 primary health care practices in Greater Glasgow, United Kingdom. We obtained numbers of prescriptions o f diuretics, ACE inhibitors, and digoxin and numbers of admissions for hear t failure. The mean practice rate of diuretic prescription was 0.7 per pati ent per year, the mean practice rate of ACE inhibitor prescription was 0.06 per patient per year, the mean practice rate of digoxin prescription was 0 .09 per patient per year, and the mean practice rate of admission for heart failure was 3.29 per 1,000 patients per year. There was a strong and signi ficant association between the rate of diuretic prescription and the rate o f digoxin prescription. There was only a moderate inverse association betwe en the ratio of ACE inhibitor to diuretic prescriptions and the rate of adm issions for heart failure. Conclusions: ACE inhibitors are underused. Rates of diuretic and digoxin pr escriptions correlate strongly and are presumably both markers for similar cardiovascular morbidity. There was no evidence that ACE inhibitors modulat ed the rate of heart failure admissions.