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- Nilsson, P, et al.
(författare)
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Gender differences in secondary prevention of coronary heart disease: reasons to worry or not?
- 2003
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 21:1, s. 37-42
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Tidskriftsartikel (refereegranskat)abstract
- Objective - To analyse potential gender differences in cardiovascular risk factors and treatment patterns, reflecting clinical practice in secondary prevention. Design - Observational national study during 3 years of patients eligible for secondary prevention of coronary heart disease (CHD). Setting - Fifty-two healthcare districts in Sweden, involving primary health care and hospitals in collaboration, participating in a national quality assurance programme for the prevention of CHD. Subjects - A national sample of male and female patients surviving acute myocardial infarction, or following CABG/PTCA interventions for CHD, controlled at 3-6 months (n=9135) and 12 months (n=4802) of follow-up. The proportion of female patients (25%) did not differ between visits. Main outcome measures - Self-reported data on lifestyle, drug treatment and cardiovascular risk factor levels after consultation in general practice or at hospital policlinics. Results - No major gender differences were recorded in risk factor levels or in cardiovascular drug treatment patterns at 12 months of follow-up. Female patients participated in educational programmes to improve lifestyle to a higher degree than males (52.0 vs 45.1%), but after 1 year were more often (p < 0.001) self-reported smokers (11.7 vs 8.4%). Female patients showed higher levels of blood pressure, total cholesterol and HDL cholesterol, but not LDL cholesterol compared to male patients. Conclusions - In general, a gender-equal level of lipid control and access to medical drug treatment has been established for patients in secondary prevention from a national sample in Sweden, followed for 1 year after CHD manifestations and related interventions.
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- Hedbäck, Bo, 1944-, et al.
(författare)
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Cardiac rehabilitation after coronary artery bypass surgery : 10-Year results on mortality, morbidity and readmissions to hospital
- 2001
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Ingår i: Journal of Cardiovascular Risk. - : Ovid Technologies (Wolters Kluwer Health). - 1350-6277 .- 1473-5652. ; 8:3, s. 153-158
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the long-term secondary preventive effect of a comprehensive rehabilitation programme after coronary artery bypass grafting (CABG). Methods: The study group included 49 consecutive patients who underwent bypass surgery and were then offered a rehabilitation programme consisting of education in risk-factor control, a physical training programme and regular follow-up at a post-CABG clinic. The control group (n = 98), consisting of two well-matched CABG patients for each study patient, was offered the usual care with no access to a cardiac rehabilitation programme. The two groups were followed for 10 years and the results regarding cardiovascular mortality, morbidity, total cardiac events and readmissions to hospital were compared. Results: The total mortality (study group 8.2%, control group 20.4%) and cardiovascular mortality (8.2 versus 15.3%) after 10 years did not differ significantly between the groups. In the study group, nine patients (18.4%) had 10 cardiac events (four cardiovascular deaths, five non-fatal myocardial infarctions and one CABG) compared to 34 patients (34.7%, P < 0.05) suffering 46 (P < 0.01) cardiac events (15 cardiovascular deaths, 18 non-fatal myocardial infarctions, eight CABG, five coronary angioplasties) in the control group. The number of readmissions to hospital (2.1 versus 3.5 per patient) and length of admissions (11 versus 26 days per patient) was significantly lower in the study group (P < 0.01). Conclusion: A comprehensive cardiac rehabilitation programme offered to patients after coronary artery bypass surgery will improve the long-term prognosis and reduce the need for hospital care.
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