Ja. De Velasco et al., Risk factor prevalence and drug treatment in coronary patients hospital discharge. Results of a multicenter registry (3C programme), REV ESP CAR, 54(2), 2001, pp. 159-168
Introduction and objectives. Based on the results of clinical trials the gu
idelines of international societies recommend secondary prevention in coron
ary heart disease patients. Several surveys have shown that the application
of these guidelines in clinical practice is not adequate. The aim of this
study was to determine the practical application of the recommendations of
these guidelines and drug prescription in patients with coronary heart dise
ase on hospital discharge.
Methods. We included 3,215 coronary patients (myocardial infarction, angina
and post-revascularization) discharged from 25 Spanish hospitals. We studi
ed the prevalence of risk factors and the medical treatment on discharge in
relation to gender, age and clinical diagnosis.
Results. We found a significantly higher prevalence of risk factors, except
for smoking, in women. With regards to age and diagnosis neither was, the
prevalence uniform, with an increase in hypertension and diabetes being pre
dominantly seen in the elderly as well as angina patients. Fifty-six point
three percent of the patients showed a total cholesterol greater than 200 m
g/dl and 88% demostrated a LDL-cholesterol greater than 100 mg/dl. The prev
alence of hypercholesterolemia and low HDL was higher among women. The pres
cription of betablockers and lipid-lowering drugs was lower than recommende
d, mainly among women and patients older than 64 years.
Conclusions. The registry of data concerning some risk factors in patient c
linical files is poor. The prevalence of risk factors is higher in women. T
he prescription of betablokers and lipid-lowering drugs is low, especially
in women and in patients over the age of 64 years. There is a need for impr
ovement in secondary prevention in coronary patients on hospital discharge.