[Cardiovascular secondary prevention]

Cardiovascular secondary prevention plays a fundamental role due to the rising average age of the population. The reorganization of the health care system is also becoming more important. Especially the needs of high-risk patients have to be prioritized. A change of habits (e. g. abnegation of nicotine, change in eating habits, obtaining a BMI<25) is the basis of preventive measures in order to maximize the effectivity of drug therapy. Here the application of statins takes center stage (if there are no contraindications) which minimizes the risk of coronary incidences by 30%. In case of high lipid blood level, fibrates have to be applied at a low level of HDL-cholesterol and omega-3 fatty acids at high values of triglycerides. Omega-3 fatty acids must be given in the form of 1 g ethyl esters of EPA and DHA, otherwise a significant reduction of fatal cardiovascular incidences cannot be proven. Recently ACE inhibitors have gained in importance because of their ability to reduce the formation of plaques. Furthermore beta-blockers and aspirin can be applied for therapeutic measures, whereas different periods of treatment are recommended by the guidelines. With the aid of algorithms it is possible to specify the risk of experiencing a second myocardial infarction.