Comparison of secondary prevention of heart disease in Europe: lifestyle getting worse, therapy getting better in Ireland.
We compared the implementation of secondary prevention some 18 months following acute myocardial infarction or coronary artery bypass surgery in Ireland in 1994 to that in 15 European countries, including Ireland, in 2000. While there were substantial improvements in the use of statins, b-blockers and the availability of rehabilitation programmes since the early 1990s, more patients now smoke, take no exercise and are overweight. The prevalence of non-insulin dependent diabetes has increased by 70%. In comparison with other European countries, we have the highest use of aspirin and the highest prevalence of smoking in women. Despite a considerable improvement in the use of drug therapy we will not achieve the full potential of secondary prevention unless lifestyle factors, including smoking, overweight and exercise receive greater attention by patients with coronary heart disease.
Hall
M
M
Department of Therapeutics and Hypertension Clinic, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8.
McGettigan
M
M
O'Callaghan
P
P
Graham
I
I
Shelley
E
E
Feely
J
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D006331:Heart Diseases / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008019:Life Style; D009660:Northern Ireland / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin