What are "Secondary Prevention Targets" and why are they significant?
In the past, your doctor
has assessed your risk of cardiac events (heart attack, stroke)
by the assessment of your cardiac risk factors such as high blood
pressure, smoking and high cholesterol to name a few. However, we
now realize that assessing risk factors alone doesn't tell us the
whole story. Risk factors do not completely account for the risk
of developing coronary artery disease, and do not accurately predict
the annual risk of having a cardiac event.
Large clinical trials have demonstrated that
secondary prevention strategies using specific treatment goals may
reduce the annual risk of future cardiac events and may actually
slow the progression of heart disease.
Secondary prevention strategies include medications
that your doctor prescribes for you, as well as lifestyle behaviours.
They encompass some of the traditional controllable risk factors
previously used such as smoking, blood pressure, cholesterol levels,
regular aerobic exercise etc. Failure to achieve the documented
targets may reduce your benefit of reducing your cardiac risk.
Some of the medications that your doctor
will prescribe, have specific secondary prevention targets or doses.
Clinical trials have demonstrated that benefits from the medications
are dose specific. For example, the HOPE study demonstrated that
Altace 10 mg once a day had a significant reduction in cardiac events
for people with known cardiovascular disease or diabetes. There
is evidence that reduced doses of these medications may not have
the same benefit. For this reason, your doctor will be working with
you to try and reach the specified target doses.
Below is a table outlining the secondary
prevention targets that you should be working towards. There are
many strategies for reaching these targets and your doctor and health
care team members will work with you to achieve these targets. You
will notice that there is space in this chart for you to write in
your current status. If you do not know your current status on these
secondary prevention targets, ask your doctor or health care team
CCRF would like to thank the Rouge Valley Health System Cardiac Rehabilitation Services for their contribution to the website.
The articles, on the Cardiac Health Foundation of Canada website, are presented with the understanding that the Foundation is providing information only and not rendering medical advise. Please check with your family physician, specialist or health care professional before implementing any of the ideas expressed in these articles.