Secondary prevention inadequate for many at high-risk for recurrent MI or stroke

החומר לקוח ממדיקונטקסט
Last Updated: 2001-07-09 11:24:15 EDT (Reuters Health)

By Steven Reinberg

WESTPORT, CT (Reuters Health) – Survivors of myocardial infarction (MI) or stoke in the US often do not receive effective secondary prevention measures, researchers from the State University of New York at Buffalo report in the July 9th issue of the Archives of Internal Medicine.

"Among people who have survived an MI or stroke, there is a very high prevalence of inadequately controlled hypertension, hypercholesterolemia and active smoking," Dr. Adnan I. Qureshi told Reuters Health.

Using data from NHANES III, Dr. Qureshi and colleagues identified 1252 patients who had survived a MI or stroke.

Among these patients, the researchers identified 738 who had been diagnosed with hypertension, 388 of whom did not have their hypertension controlled. In addition, previously undiagnosed hypertension was found in another 138 patients.

Furthermore, among the 289 patients with diabetes, glucose levels in 141 were inadequately controlled, Dr. Qureshi's team notes. Also, among all 1252 patients, 225 were current smokers and 56 were heavy alcohol users.

Hypercholesterolemia was poorly controlled in 185 of 405 patients, the researches add. They also found that, of the total cohort, 160 patients had undiagnosed hypercholesterolemia.

"We don't know for sure how much contribution to this problem comes from the patients' attitude toward risk modification and how much from physicians not instituting secondary prevention measures," Dr. Qureshi said, "but we know there are contributions from both sides."

Dr. Qureshi stressed that "physicians need to be more aggressive in monitoring and evaluating their patients when they have left the hospital, and patients need an attitude modification to be sure they modify their risk factors. In addition, healthcare policy makers need to realize that a lot more effort needs to go into secondary prevention."

Arch Intern Med 2001;161:1621-1628.

-Westport Newsroom 203 319 2700

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