Abstract
Introduction: Secondary prevention after myocardial infarction is at least as important as treatment of the acute phase. Improved cardiovascular (CV) prevention can decisively contribute to the continuation of positive trends of CV morbidity and mortality seen in the Czech Republic in last three decades.
Objectives: To determine, in patients with coronary heart disease (CHD), how the treatment goals as defined by the current European guidelines on CV secondary prevention (2012) are implemented in clinical practice. Methods: Patients = 30), 85.5% were overweight or obese (BMI >= 25), 70.2% had central obesity (waist circumference >= 102 cm in men, >= 88 cm in women), the recommended level of physical activity (30 minutes 5 times a week) was not attained by 85%.
Raised blood pressure (>= 140/90 mmHg, in diabetics >= 140/80 mmHg) was measured in 55.1%, elevated LDL-cholesterol (>= 1.8 mmol/L) in 63.5% of responders. Manifest diabetes mellitus (known plus newly discovered at interview) was present in 41.2%, and prediabetes in 23.4% of patients.
The respective figures when using the oral glucose tolerance test (OGTT) were 44.7% and 32.3%. At interview, 88.4% of patients were being treated with aspirin or other antiplatelet drugs, 81.3% with beta-blockers, 78.8% with ACE inhibitors or angiotensin receptor blockers (ARBs), 92.1% with statins, and 92.9% had undergone revascularization.
Conclusion: The majority of coronary patients have unhealthy lifestyles such as unhealthy diet and sedentary behavior. The prevalence of overweight, obesity, and diabetes is very high, and prevalence of obesity further increased.
Although pharmacotherapy is used in the majority of patients, the recommended levels of blood pressure, lipid, and glucose metabolism are achieved in only a minority.