How well are patients with atherosclerotic disease treated? Secondary prevention in primary care

Objective - To examine changing trends in the held of secondary prevention of atherosclerotic disease in Norwegian general practice. Design-A multipractice survey of consecutive patients with atherosclerotic disease consulting general practitioners in 1994/95 compared with a similar survey in 1996/97. Setting - Primary health care. Subjects - 707 patients attending 31 general practitioners in 1994/95 and 1353 patients attending 63 general practition ers in 1996/97. Main outcome measures - The patients were examined and interviewed for risk factors and pharmacological treatment. Results - In 1994/95, 18% of the patients had been prescribed a lipid-lower ing agent as opposed to 55% in the later survey. Consequently, the average level of LDL cholesterol in the 1996/97 population was 19% lower than in th e 1994/95 population (3.8 mmol/l vs 4.7 mmol/l), which may imply a marked r isk reduction. Aspirin and beta-blockers were prescribed to approximately 5 0% of the patients in both surveys. Diabetic patients had the same drug pre scription rate and lipid profile as non-diabetics. In both surveys, about 2 5% of the patients were smokers. Conclusion - Secondary prevention in the majority of patients with atherosc lerotic disease though ameliorating is still unsatisfactory. More attention is needed to achieve and sustain treatment goals.