title: Prevalence of traditional cardiac risk factors and secondary prevention among patients hospitalized for acute myocardial infarction (AMI): variation by age, sex, and race.
abstract: BACKGROUND
  Modification of traditional cardiac risk factors is an important goal for patients after an acute myocardial infarction (AMI). Risk factor prevalence and secondary prevention efforts at discharge are well characterized among older patients; however, research is limited for younger and minority AMI populations, particularly among women.
  
  
  METHODS
  Among 2369 AMI patients enrolled in a 19-center prospective study, we compared the prevalence and cumulative number of five cardiac risk factors (hypertension, hypercholesterolemia, current smoking, diabetes, obesity) by age, sex, and race. We also compared secondary prevention strategies at discharge for these risk factors, including prescription of antihypertensive or lipid-lowering medications and counseling on preventive behaviors (smoking cessation, diabetes management, diet/weight management).
  
  
  RESULTS
  Approximately 93% of patients had ≥1 risk factor, 72% had ≥2 factors, and 40% had ≥3 factors. The prevalence of multiple risk factors was markedly higher for blacks than for whites within each age-sex group; black women had the greatest risk factor burden of any subgroup (60% of older black women and 54% of younger black women had ≥3 risk factors). Secondary prevention efforts for smoking cessation were less common for black compared with white patients, and younger black patients were less often prescribed antihypertensive and lipid-lowering medications compared with younger white patients.
  
  
  CONCLUSIONS
  Multiple cardiac risk factors are highly prevalent in AMI patients, particularly among black women. Secondary prevention efforts, however, are less common for blacks compared to whites, especially among younger patients. Our findings highlight the need for improved risk factor modification efforts in these high-risk subgroups.
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut 06519, USA. erica.leifheit-limson@yale.edu
authors.forename: Erica C
authors.initials: EC
authors.lastname: Leifheit-Limson
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Reid
authors.forename: Sara B
authors.initials: SB
authors.lastname: Jones
authors.forename: Viola
authors.initials: V
authors.lastname: Vaccarino
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
authors.forename: Judith H
authors.initials: JH
authors.lastname: Lichtman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000453:epidemiology; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology*; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016540:Smoking Cessation; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data*