Risk Factor Modification for Vascular Disease in North Carolina Prisons

Abstract

The medical needs of the incarcerated population in the United States are growing, requiring appropriate management within the carceral health care system. This article examines adherence to prescribing guidelines for common vascular risk factors among incarcerated patients referred for vascular surgery evaluation in North Carolina between 2019 and 2023. Medical records of 57 patients with noncoronary atherosclerotic disease were reviewed. At referral, 66.6% were prescribed an antiplatelet agent, and 61.4% were on a statin, with 49.1% receiving both. Among the 82.5% with hypertension, 87.2% were prescribed antihypertensives. Of the 50.8% with diabetes, 72.4% received antihyperglycemics, and among patients with hyperlipidemia (43.9% of the total), 84.0% were prescribed lipid-lowering medication. Although treatment of hypertension and diabetes was generally guideline-concordant, gaps remain in statin and antiplatelet prescribing.