Family Practice Vol. 21, No. 5 © Oxford University Press 2004, all rights reserved.
The challenge of secondary prevention for coronary heart disease in older patients: findings from the British Women's Heart and Health Study and the British Regional Heart Study
a Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, b Department of Public Health Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE and c Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3 2PF, UK; E-mail: d.a.lawlor{at}bristol.ac.uk
Background. Secondary prevention of coronary heart disease (CHD) among older individuals is associated with considerable benefit.
Methods. In this study, we have examined the extent of secondary prevention among British women and men aged 60–79 years who were surveyed and examined between 1998 and 2001.
Results. Among 483 women (12.1% of the whole sample) and 831 men (19.5%) with CHD, >90% of both sexes had at least one modifiable risk factor, with over two-fifths having high blood pressure and over three-quarters high cholesterol. For total cholesterol and body mass index, mean values in both male and female subjects were above recommended levels, and a large shift in the population distributions would be required for targets to be met. Less than one-quarter of subjects of either sex were on a statin, and whilst the majority of men were taking an antiplatelet medication, only 40% of women were.
Conclusions. Most older women and men in Britain were failing to meet National Service Framework standards for secondary prevention in the period immediately before its implementation. Large shifts in the population distributions of some risk factors would be required in this group to meet these standards.
Keywords. Coronary heart disease, secondary prevention, aspirin, statin, older age.
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