Evidence supporting secondary prevention strategies.
Currently 14 million individuals in the United States have coronary disease. Within the next 2 decades, this number is expected to increase to 21 million persons. To minimize the excessive risk of recurrent cardiac events in these people, evidence-based, cost-effective prevention strategies must be developed. This review highlights the evidence supporting commonly used means of secondary prevention and is divided into two major sections: lifestyle modifications and pharmacologic interventions. Lifestyle changes discussed include smoking cessation, especially newer pharmacologic adjuncts; the efficacy of dietary interventions; and current inroads into the treatment of depression in recurrent events. Pharmacologic innovations include reexamination of a role for warfarin; continued advances in the treatment of hyper- and dyslipidemias, new roles for beta-blockade in congestive heart failure, and finally a view of future measures, risk and targets of risk intervention.
Blazing
M A
MA
Duke University Medical Center, Durham, NC 27710, USA. Blazi001@mc.duke.edu
O'Connor
C M
CM
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003327:Coronary Disease / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy / Q000517:prevention & control*; D015914:Estrogen Replacement Therapy; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008019:Life Style; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents; D000960:Hypolipidemic Agents