Secondary prevention of ischemic heart disease at the lipid-related level in primary care in Aragon. Assessment Study PRECIAR 1

Abstract

Background: Despite the existing evidence of the effectiveness of secondary prevention by modifying lifestyles or using the different drugs which have shown themselves to be clinically beneficial for heart patients, there is little, not highly accurate information available regarding the handling of the treatment of these patients within the scope of primary care in our country. The purpose of this study is that of ascertaining the current status of secondary prevention of heart disease as far as lipid control is concerned. Methods: A review was made of the clinical records of all of the patients diagnosed at some point in time of their life as having ischemic heart disease, including those under the heading of acute myocardial infarction and angina pectoris within the 11 groups of patients assigned to three urban Health Care Centers in Area II in Zaragoza. The population in question totaled 19,692 patients, 388 cases of ischemic heart disease having been found in the record files data. Results: Based on a study of the lipid control data, 60.8% of the cases analyzed in this study showed a complete lipid profile for the last year. Solely 4.7% of these patients had LDL<100, the control objective having to be limited to c- LDL<130 to find a 31.3% of patients with a lower than optimum control of this parameter. Conclusions: The results of our study reveal that the diagnosis of dyslipemias as well as the control of all other heart disease risk factors in secondary care have not been in keeping, for the most part, with the quality criteria of this health care procedure and therefore reveal the existence of a major degree of room for improvement.