EDITORIALS

Maximising secondary prevention therapies in patients with coronary heart disease

S Capewell, M O’Flaherty

Division of Public Health, University of Liverpool, UK

Correspondence to:
Dr S Capewell, Division of Public Health, Whelan Building, Quadrangle, University of Liverpool, L69 3GB, UK; m.oflaherty@liverpool.ac.uk

The first 150 words of the full text of this article appear below.

Population-based primary prevention strategies are the only affordable solution for most developing countries. However, wealthier countries have the luxury of being able to support the complementary strategies of primary and secondary prevention. Ideally, almost all patients with coronary heart disease (CHD) can change their behaviour (smoking cessation, healthy diets and exercise-based rehabilitation) and receive secondary prevention medications (antiplatelet therapy, statins, ACE inhibitors and β-blockers, if there are no specific clinical contraindications).¹

Secondary prevention drugs are important; they may explain about 10% of the fall in CHD death rates seen in the UK population between 1981 and 2000, much as in the USA between 1980 and 2000 and elsewhere.^{2 3} Furthermore, secondary prevention medicine is relatively cheap and cost effective.⁴

Recognising that uptake by 100% of eligible patients with CHD might be unrealistic, the UK CHD National Service Framework (NSF) in 1999 sensibly started with 80% targets. Yet even these remain challenging, . . . [Full text of this article]

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