[Risk factors and intervention in cardiovascular diseases in general practice]

The authors conducted a cross-sectional study including 707 patients with chronic ischaemic heart disease or obstructive peripheral atherosclerotic disease. The patients were monitored by 31 general practitioners in different parts of Norway, from October 1994 to April 1995. 67% of the patients were male and 33% were female. 28% were smokers. In this study the majority of the patients were being adequately treated for hypertension, and the prevalence of antithrombotic treatment with either warfarin or acetylsalicylic acid was comparable with the results from recent intervention trials, for instance the Scandinavian Simvastatin Survival Study (4S). More than 90% of the patients had levels of total cholesterol and LDL-cholesterol which, based on today's international consensus, implied giving dietary advice and treatment with statin-type drugs in order to increase survival and reduce morbidity once atherosclerotic disease has been diagnosed. In this study less than 20% received statins, and only a minority of those treated had reached the established goals for treatment. Based on this study we recommend that much stronger emphasis is placed on serum-cholesterol level reduction in patients with established atherosclerotic disease, both by specialists and in primary health care.