title: Secondary prevention in coronary artery disease. Achieved goals and possibilities for improvements.
abstract: OBJECTIVE
  To describe presence of risk indicators of recurrence 6 months after hospitalisation due to coronary artery disease at a university clinic.
  
  
  METHODS
  The presence of risk indicators, including tobacco use, lipid levels, blood pressure and glucometabolic status, including 24-hour blood pressure monitoring and an oral glucose-tolerance test, was analysed.
  
  
  RESULTS
  Of 1465 patients who were screened, 402 took part in the survey (50% previous myocardial infarction and 50% angina pectoris). Mean age was 64 years (range 40-85 years) and 23% were women. Present medications were: lipid lowering drugs (statins; 94%), beta-blockers (85%), aspirin or warfarin (100%) and ACE-inhibitors or angiotensin II blockers (66%). Values above target levels recommended in guidelines were: a) low density lipoprotein (LDL) in 40%; b) mean blood pressure (day or night) in 38% and c) smoking in 13%. Of all patients, 66% had at least one risk factor (LDL or blood pressure above target levels or current smoking). An abnormal glucose-tolerance test was found in 59% of patients without known diabetes. If no history of diabetes, 85% had either LDL or blood pressure above target levels, current smoking or an abnormal glucose-tolerance test. However, with treatment intensification to patients with elevated risk factors 56% reached target levels for blood pressure and 79% reached target levels for LDL.
  
  
  CONCLUSIONS
  Six months after hospitalisation due to coronary artery disease, despite the high use of medication aimed at prophylaxis against recurrence, the majority were either above target levels for LDL or blood pressure or continued to smoke.
authors: Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors: Berglind
authors: B
authors: Libungan
authors: Lillemor
authors: L
authors: Stensdotter
authors: Agneta
authors: A
authors: Hjalmarson
authors: Mona
authors: M
authors: From Attebring
authors: Jonny
authors: J
authors: Lindqvist
authors: Maria
authors: M
authors: Bäck
authors: Johan
authors: J
authors: Herlitz