[Effectiveness of a health network in secondary prevention among coronary patients].
OBJECTIVE
To improve the secondary prevention, particularly hypertension management among coronary patients.


METHODS
In 2004-2005, out of 175 coronary patients having taken part in a cycle of the Educoeur center of the health network Rivarance, 131 (75%) aged between 32-79 years of age (an average of 61 years with 11% women, 52% hypertensive, 24% smokers, 10% diabetics and 72% with unbalanced dyslipidemia (LDL>1g/l)) were re-examined within 12 months and were compared with a French cohort of the EuroAspire II study (365 patients - Lancet 2001). 56% were treated by angioplasty, 24% by coronary bypass and 20% by medical treatment. The 4-week ambulatory educational program consisted of a physical education with 22 meetings of cardiac rehabilitation (ergo cycle, carpet, segmentary muscular work, steps and balneotherapy) and a therapeutic and dietetic education (18 courses and cooking workshops, supermarket visits and self BP measurement). These 131 patients were re-examined 3, 6 and 12 months after by the paramedical team. The GP and nurses were taught recommendations on CV risk factors management. The patients were followed by a computerized medical file. BP (average of 3 measurements by OMRON M4), total cholesterol (CT), weight, physical activity (insufficient if less than 3 walks of 30 min per week), smoking and drugs intake were analyzed on J0 then at one year and were compared with the French results of EuroAspire II. [table: see text]


CONCLUSIONS
The education and the follow-up of the patient in a network of health improve CV risk factors and particularly hypertension management of these coronary patients but this decreases with time.
Denolle
T
T
Centre Educoeur, Réseau RivaRance, Dinard - Saint-Malo.
Sharareh
A
A
Dib
M
M
Agaesse
M-F
MF
Auguste
V
V
Boutier
H
H
Bouvet
C
C
Maillard
J
J
Richard
A
A
Revault d'allonnes
F
F
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000706:statistics & numerical data; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D019058:Community Networks; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000453:epidemiology* / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control; D004032:Diet; D015444:Exercise; D005260:Female; D005602:France / Q000453:epidemiology; D015438:Health Behavior; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000453:epidemiology / Q000517:prevention & control; D006973:Hypertension / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation; D000074606:Smoking Prevention
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors