PHARMACOLOGICAL TREATMENT, LIFESTYLE MODIFICATION AND AWARENESS IN CORONARY ARTERY AND CEREBROVASCULAR DISEASE PATIENTS

Abstract INTRODUCTION: Cardiovascular diseases (CVD) and cerebrovascular diseases (CeVD) are a large and growing problem in low- and middle-income populations. Secondary prevention, which can reduce the risk of recurrent CVD includes changes in lifestyle, pharmacological interventions and revascularization procedures. The aim of the first phase of this project was to perform situation analysis and identify gaps in secondary prevention of major cardiovascular diseases. This study estimated the physicians' awareness and the patients' knowledge and behavior towards CVD and CeVD complications. It also assessed the efficacy of methods for decreasing recurrent events. methods: A sample of consecutive patients was selected from the outpatient units of the health care facilities selected for the study. Stratified random sampling of primary and secondary private and public health care facilities in cities and villages was performed to select ۴۴۹ eligible cases. A total of ۲۵۷ men and ۱۹۲ women were selected. The inclusion criteria were as follows: Age above ۲۱ years, established diagnosis of CVD and/or CeVD defined as any of the following alone or in combination with others: previous myocardial infarction, stable/unstable angina, percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG), stroke, transient ischemic attack (TIA), and/or carotid arterectomy. The patients were included if their first event had occurred more than a month, but no earlier than three years before the study. results: The prevalence of high systolic and diastolic blood pressure was ۴۰.۱% and ۲۶.۹% respectively in MI patients, and ۷۰.۱% and ۵۱.۲% respectively in CeVD patients. In most of the patients, fasting blood sugar and total cholesterol were within the normal range. Among MI patients, ۹۳.۹%, ۶۸.۵% and ۴۸.۲% were already taking aspirin, beta-blockers and statins, respectively. Among CeVD patients, ۷۹.۹%, ۶۱.۱% and ۲۳.۲% were taking aspirin, beta-blockers and statins, respectively. Blood pressure had been managed in ۹۴.۹% and ۹۳.۷% of MI and CeVD patients, respectively. Among MI patients, ۸۵.۸% and ۸۳.۲% had correct behavior towards blood sugar and cholesterol control and ۶۸% had adequate knowledge of the risk of recurrent events. DISCUSSION: Secondary prevention of vascular diseases should be regarded as a key component of public health strategies to reduce the rising burden of CVD and CeVD in Iran.Keywords • Lifestyle modification • Awareness • Myocardial infarction • CeVD