Introduction and objectives: Based on the results of clinical trials the guidelines of international societies recommend secondary prevention in patients. Several surveys have shown that the application of these guidelines in clinical practice is not adequate. The aim of this study was to determine the practical application of the recommendations of these guidelines and drug prescription in patients with coronary heart disease on hospital discharge.
Methods: We included 3,215 coronary patients (myocardial infarction, angina and post-revascularization) discharged from 25 Spanish hospitals. We studied the prevalence of risk factors and the medical treatment on discharge in relation to gender, age, and clinical diagnosis.
Results: We found a significantly higher prevalence of risk factors, except for smoking, in women. With regards to age and diagnosis neither was, the prevalence uniform, with an increase in hypertension and diabetes being predominantly seen in the elderly as well as angina patients. Fifty-six point three percent of the patients showed a total cholesterol greater than 200 mg/dl and 88% demonstrated a LDL-cholesterol greater than 100 mg/dl. The prevalence of hypercholesterolemia and low HDL was higher among women. The prescription of betablockers and lipid-lowering drugs is low, especially in women and in patients over the age of 64 years.
Conclusions: The registry of data concerning some risk factors in patient clinical files is poor. The prevalence of risk factors is higher in women. The prescription of betablockers and lipid-lowering drugs was lower than recommended, mainly among women and patients older than 64 years. There is a need for improvement in secondary prevention in coronary patients on hospital discharge.