Abstract
Significant increase in mortality from coronary heart disease (CHD) has been seen in Bosnia and Herzegovina in the past decade. Little is known about current secondary preventive practices and treatments among patients with CHD in primary health care. The aims of this study were to evaluate the components of secondary prevention for CHD and to detect possible gender differences. This trial included 70 patients, aged 40-70 years, with established CHD from Family Medicine Teaching Center Tuzla. We evaluated components of secondary prevention (serum total cholesterol and blood pressure levels, smoking habits, body mass index, using aspirin, ACE inhibitors and lipid lowering drugs) in all participants. Results showed that significantly more men than women had diagnosis of CHD. 26/70 (37.14%) patients had myocardial infarction, with significantly higher number of men than women, but more women had angina only. Mean systolic blood pressure was 148.09+/-20.22 and diastolic 91.62+/-10.17 mmHg; mean total cholesterol level was 6.23+/-1.33 mmol/l; mean BMI was 27.9+/-3.32 kg/m(2). Blood pressure was managed according to guidelines in 19 (27.14%), and lipid concentrations in 11 (15.71%) patients. 55/70 (78.71%) patients took aspirin, only 18/70 (25.71%) patients took lipid lowering therapy, and 20/23 (86.96%) patients with heart failure took ACE inhibitors. 16/70 (22.86%) patients were current smokers, only 19/70 (27.14%) patients had healthy body mass index, while 21/70 (30%) patients were obese. Results of this study show a suboptimal secondary prevention in primary health care, which indicate more effective public health messages and changes in the healthcare system that promotes preventive strategies.
Highlights
Cardiovascular disease is leading cause of death in industrial countries all over the world and represents a continuing crisis of epidemic proportions
Most people with coronary heart disease come in primary care office with aim that primary healthcare professionals be a persons who will suggest and give advice regarding to regular using antihypertensive medications, antiplatelets agents, lipid lowering therapy, as well as lifestyle modifications, so family physicians and general practitioners have been encouraged to target them for secondary prevention
It is well known that treatment with aspirin and lipid lowering therapy can reduce cardiovascular events in patients with coronary heart disease
Summary
Cardiovascular disease is leading cause of death in industrial countries all over the world and represents a continuing crisis of epidemic proportions. Migrations, political and economic instability in the country, increasing of mental health disorders, smoking and alcohol consumption, and unhealthy diet had negative effects on people health. These current and past adverse situations have resulted in increasing prevalence of cardiovascular disease, especially coronary heart disease. Most people with coronary heart disease come in primary care office with aim that primary healthcare professionals be a persons who will suggest and give advice regarding to regular using antihypertensive medications, antiplatelets agents, lipid lowering therapy, as well as lifestyle modifications, so family physicians and general practitioners have been encouraged to target them for secondary prevention.
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