UK-NZ disagreement on actions necessary to record
| *Actions based mainly on strong scientific evidence. | |
| Actions necessary to record in NZ but not UK | |
| Initial assessment of angina | Duration of anginal episodes |
| Discussion of diet* | |
| Annual review | Duration of anginal episodes |
| Auscultation (heart) | |
| Body mass index or weight, if previously abnormal | |
| Smoking, if previously noted to be a current smoker or to have quit smoking within the past six months* | |
| Cholesterol treatment | Offer of drug treatment for cholesterol ⩾5.5 mmol/l after 3–6 months of dietary therapy* |
| Blood pressure treatment | Diagnosis of diabetes and, after symptomatic drug treatment, systolic blood pressure ⩾140 mm Hg |
| Regular symptomatic treatment: | |
| Monotherapy | Verapamil or diltiazem when there is a contraindication to β blockade |
| Offer as second line treatment | Verapamil, diltiazem or a long acting dihydropyridine if on an oral nitrate and β blockade is contraindicated |
| Three drug treatment | Offer of third drug to the patient still symptomatic on two drug therapy |
| Referral to a cardiologist and for exercise testing | Offer of referral to a cardiologist unless not a candidate for revascularisation |
| Actions necessary to record in UK but not NZ | |
| Initial assessment | Haemoglobin |
| Blood pressure treatment | All male patients with cholesterol >5.5 mmol/l and a systolic blood pressure >140 mm Hg |
| All women patients under 70 with a cholesterol >5.5 mmol/l and a systolic blood pressure >140 mm Hg | |
| Risk factor recording: | Offer of advice on exercise |
| Referral to a cardiologist and for exercise testing: | If any drug has been prescribed for angina, including aspirin and sublingual nitrates |
| The patient has previously been revascularised, has not had an exercise test, is more than minimally symptomatic, and is on two or more maintenance drugs | |