Background Coronary heart disease (CHD) is the leading cause of
death in the developed world. We studied compliance to a secondary prevention
programme for CHD patients and possible gender differences.
Design and methods Cross-sectional survey of CHD patients aged up to
75 years attending a hospital cardiology outpatient clinic (n
= 441; 16 cardiologists) and 12 primary care centres
(n = 319; 28 primary care physicians), by means of a
questionnaire.
Results Therapeutic goals in hospital care and in primary care were
reached by 36% and 29% (P <
0.05) for cholesterol, 42% and 50% (P
< 0.01) for triglycerides, 66% and 72% for
blood glucose, 84% and 86% for blood pressure, and
16% and 20% for smoking, respectively. Echocardiography
was more frequent in hospital care patients (odds ratio 2.69, P
< 0.001). ACE-inhibitors, β-blockers, antiplatelet and
anticoagulant therapy were prescribed similarly in both groups, antidiabetics
were less common in hospital care (odds ratio 0.53, P
< 0.05). Men were more often subject to echocardiography (odds ratio
2.59, P < 0.001). ACE-inhibitors (odds ratio 2.04,
P < 0.01), β-blockers (odds ratio
1.82, P < 0.001) and antiplatelet or anticoagulant
drugs (odds ratio 1.82, P < 0.01) were more common
in men; diuretics (odds ratio 0.49, P < 0.01) were
more common in women.
Conclusions CHD patients have a high prevalence of modifiable risk
factors. Few reach therapeutic goals for lipid levels, whereas other risk
factors are better controlled. A secondary prevention programme is an important
aid in preventing CHD but must be followed by further educational efforts in
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