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Challenges in coronary heart disease prevention - experiences from a long-term follow-up study in Norway

E Sverre1,2, K Peersen3, J Perk4

  • 1Department of Medicine, Drammen Hospital, Drammen, Norway.

Scandinavian Cardiovascular Journal : SCJ
|December 4, 2020
PubMed

Insights

Lifestyle behaviors and lipid management in chronic coronary heart disease (CHD) patients remained suboptimal over 4.7 years. Increased physical inactivity and persistent risk factors highlight the need for intensified secondary prevention strategies.

Area of Science:

  • Cardiology and Cardiovascular Health
  • Public Health and Epidemiology
  • Behavioral Medicine

Background:

  • Chronic coronary heart disease (CHD) management requires ongoing lifestyle and lipid control for secondary prevention.
  • Longitudinal data on risk factor management in post-CHD populations are crucial for evaluating healthcare effectiveness.

Purpose of the Study:

  • To assess longitudinal changes in lifestyle behaviors and lipid management among patients with established coronary heart disease (CHD).
  • To identify trends in modifiable risk factors and medication adherence over a 4.7-year follow-up period.

Main Methods:

  • A multi-center cohort study involving 1127 CHD patients, with follow-up data collected from 707 participants.
  • Data collection included hospital records, questionnaires, and clinical examinations, with analysis using univariate statistics.
  • Baseline data were collected 16 months post-CHD event, with follow-up conducted in 2019.

Main Results:

  • Over 4.7 years, smoking, obesity, anxiety, and depression rates remained largely unchanged, but low physical activity increased from 53% to 58%.
  • Statin use remained high (92-94%), with increased use of high-intensity statins (49% to 54%) and ezetimibe (5% to 15%).
  • Only 73% reported primary care consultations for CHD in the past year; non-attendees had higher smoking rates.

Conclusions:

  • Coronary heart disease outpatients exhibit persistent suboptimal risk factor control during long-term follow-up.
  • Intensified risk management, including lifestyle and psychological support, is essential for improving secondary prevention and patient outcomes.
  • Enhanced primary care follow-up may be necessary to address persistent risk factors like smoking.

Keywords:
Coronary heart diseaselifestylelong-term follow-uppsychosocial factorsrisk factorssecondary prevention

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