Adherence to Guidelines of Secondary Prevention in patients with Ischemic Heart Disease in a Tertiary Cardiac Center

Abstract

Background: Coronary heart disease (CHD) is the leading cause of death in United State (U.S.). Controlling of modifiable risk factors such as smoking, hypertension (HT), diabetes mellitus (D.M.), dyslipidemia, physical inactivity & obesity will prevent other serious cardiovascular complications.

Objective: This study was designed to determine the adherence of the patients who were known to have ischemic heart disease (I.H.D.) to the ACC/ AHA Guidelines of secondary prevention of I.H.D.

Patients  and  methods : This is an outpatient  base  study ,was  conducted at the Iraqi Center of  Heart Disease  outpatient clinic  from    1^st. of  October  2009 till 31^st. of  March  2010.Where  two  hundred & forty tow  (242) patients were selected. Variable data were taken from the patients as follows: age, gender.  Level of education, type of I.H.D., smoking habits, body weight &height, hypertensive patients, the control of blood sugar by measuring of HbA1c level for the diabetic patients. Fasting lipid profile, renal function testes, Hb also were tested. Baseline cardiac investigations in  form of CXR, ECG, Echocardiography , TMT & previous coronary angiography were reviewed  & finally several questioners for the patients regarding their disease, risk factors, cardio protective drugs &times of visits their physicians during a month.

Results: One hundred & sixty seven patients (69%) were smokers, (65%) of them quit smoking. (64%) were hypertensive, 57 % of them had uncontrolled HT. 16.5 % were diabetics, 90% of them had uncontrolled D.M. which is estimated by measurement of Hb1Ac < 7%. (69%) were overweight, 24.4% of them were obese.

Conclusion: Most of the patients included in the study were not reaching a goal according to AHA/ACC Guidelines of secondary prevention apart from quit smoking & this may put them at high risk of development of further life threatening cardiovascular events like: recurrent ischemia, acute coronary syndrome, heart failure or even death.

Keywords: Ischemic heart disease, ACC/AH Guideline, secondary prevention