High prevalence and suboptimal treatment of risk factors in Greek coronary patients

We assessed the current clinical practice in relation to secondary prevention of coronary heart disease in a general district hospital in Greece.

A total of 819 consecutive patients ( < 75 years) with a history of myocardial infarction (> 6 months) was recruited from the outpatient cardiology clinic. All patients were interviewed and blood was taken for lipids and glycosylated haemoglobin measurements. Thirty-one percent of the patients were obese (body mass index > or = 30 kg/m2), 36% smoked cigarettes, 25% were diabetic and 36% were treated for hypertension. Reported prophylactic medication was aspirin 89%, beta-blockers 61%, angiotensin-converting enzyme inhibitors 33% and hypolipidaemic drugs 28%. Of those taking hypolipidaemic drugs 21% had achieved LDL cholesterol < 115 mg/dl while in total only 15% had LDL cholesterol < 115 mg/dl. Patients aware about the target cholesterol levels had lower cholesterol levels from those unaware (217 +/- 36 versus 231 +/- 46 mg/dl, p = 0.0001). Only 50% of the coronary patients had desirable blood pressure levels (both systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) and half of the diabetic patients had an optimal glucose control (glycosylated haemoglobin < 7.5%).

Our results show a high prevalence and suboptimal management of modifiable risk factors in Greek coronary patients. This should alert physicians and cardiologists to encourage their patients for effective lifestyle interventions together with more vigorous management of hyperlipidaemia, hypertension and diabetes and appropriate use of prophylactic drugs.