HOW CAN PRIMARY PREVENTION OF CORONARY HE ART-DISEASE BE AMELIORATED IN PRACTICE

Background: The basic issue of primary prevention strategies of corona ry heart disease is an individually adapted cardiovascular risk factor management. However, transformation of these strategies by health car e professionals is still insufficient, as was demonstrated by three st udies performed in private practice. Methods and results: In oral gluc ose tolerance tests performed in 234 patients with essential hypertens ion who were under regular medical control, 25,6% turned out to have p reviously unknown diabetes and 41,4% had impaired glucose tolerance. I n the remaining 33,3% with normal glucose tolerance, mean total serum cholesterol was 260 mg/dl. 82 patients with essential hypertension and known diabetes had a mean total serum cholesterol of 276 mg/dl. Neith er cohort was under lipid lowering drugs. Out of 290 unselected patien ts treated for type 11-diabetes in private practice, 62% were hyperten sive. Of those, hypertension was not known untreated or not sufficient ly treated in 78,2%. Conclusion: As a consequence, in patients at high cardiovascular risk, not only the ''leading'' disease (i.e. diabetes, hypertension, hyperlipidaemia), but also the concomitant constellatio n deserves attention and early intervention.