The ischaemic heart disease protocol includes some measurable criteria and some that are less easy to measure. We aim to provide an annual review. A computer template that enters a code in the computer record is used to enter data from this review so the entry of the code gives an indication of the annual review activity. Measurement of BP, recording of smoking, alcohol consumption and weight are also measurable criteria of IHD monitoring. Cholesterol and aspirin use are examined in other audits.

This audit was carried out on 19.7.00. There were 288 patients with IHD, 5% of the practice population. Of these:-

115 (40%) had a code for coronary heart disease monitoring in the past year
195 (68%) had a recorded systolic blood pressure in the past year
283 (98%) had their smoking status recorded
228 (79%) had their alcohol consumption recorded
242 (84%) had their weight recorded

The population's details have been further examined to look at BP levels. There were 151 men and 137 women with IHD. Of the 288 there were BP readings available for 281.

151/281 (54%) had a systolic reading of >140 mmHg, the target for patients with IHD
55/281 (20%) had a diastolic reading of >85 mmHg, the target for patients with IHD.

Of the seven who had not had a BP reading it was not appropriate to obtain one in four of the patients due to very advanced age or serious co-morbidity.

There is obviously a good deal of work to be done, particularly in reducing systolic blood pressures. The current figures reflect the difficulty of getting BP down without overloading patients with drugs but it also reflects the emphasis in the new guidelines on dealing with both systolic and diastolic blood pressures and the reduction of the target BP to be achieved.