Secondary prevention of coronary heart disease in primary care: a healthy heart initiative.
We assessed the effectiveness of secondary prevention of coronary heart disease (CHD) in primary care, in a cross-sectional study of 1015 patients aged < 75 years with documented CHD. Patients records were examined for documentation of CHD risk factors; 722 patients then attended education sessions where blood pressure and cholesterol were measured, a supervised questionnaire detailing modifiable risk factors was completed, and advice on lifestyle modification was given. Management of risk factors was generally poor, and was worse in women. Approximately 20% of subjects remained hypertensive, with half of these receiving anti-hypertensive medication. Examining the primary care records, serum cholesterol was documented in 17.5% of men and 26.5% of women. Of the 722 subjects who had cholesterol measured, 30% of men and 25% of women had cholesterol < 5.2 mmol/l. Mean cholesterol was significantly higher in the women (6.1 mmol/l vs. 5.6 mmol/l, p = 0.001). Lifestyle risk management was also poor, with significant numbers smoking and drinking more than recommended. Women were more overweight than men (mean BMI 27.9 kg/m2 vs. 26.9 kg/m2, p = 0.006). Aspirin was being taken by 56% of patients.
Flanagan
D E
DE
Bournemouth Diabetes and Endocrine Centre, UK.
Cox
P
P
Paine
D
D
Davies
J
J
Armitage
M
M
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003327:Coronary Disease / Q000517:prevention & control*; D005260:Female; D006266:Health Education; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D015431:Weight Loss
D000959:Antihypertensive Agents; D001241:Aspirin