Secondary prevention of coronary heart disease in primary care: a healthy heart initiative

We assessed the effectiveness of secondary prevention of coronary heart dis ease (CHD) in primary care, in a cross-sectional study of 1015 patients age d <75 years with documented CHD. Patients records were examined for documen tation of CHD risk factors; 722 patients then attended education sessions w here blood pressure and cholesterol were measured, a supervised questionnai re detailing modifiable risk factors was completed, and advice on lifestyle modification was given. Management of risk factors was generally poor, and was worse in women. Approximately 20% of subjects remained hypertensive, w ith half of these receiving antihypertensive medication. Examining the prim ary care records, serum cholesterol was documented in 17.5% of men and 26.5 % of women. Of the 722 subjects who had cholesterol measured, 30% of men an d 25% of women had cholesterol <5.2 mmol/l. Mean cholesterol was significan tly higher in the women (6.1 mmol/l vs. 5.6 mmol/l, p == 0.001). Lifestyle risk management was also poor, with significant numbers smoking and drinkin g more than recommended. Women were more overweight than men (mean BMI 27.9 kg/m(2) vs. 26.9 kg/m(2), p==0.006). Aspirin was being taken by 56% of pat ients.