Prevention of Coronary Heart Disease in Practice

IDEALLY, coronary heart disease should be prevented before it becomes clinically manifest, but whenprimary preventionfails, prevention of death and recurrent myocardial infarction after the first event, orsecondary prevention, is still a worthwhile and achievable goal. Therefore, a review of the results of recent clinical trials on both secondary and primary prevention of coronary heart disease, and of their implications for clinical practice, would seem to be timely and useful. SECONDARY PREVENTION OF CORONARY HEART DISEASE A previous history of myocardial infarction is a recognized risk factor for recurrent events, including sudden death. This review reports on recent clinical trials on the efficacy of platelet-active drugs, β-adrenergic blockers, and lowering blood cholesterol regimen in treatment of this high-risk group of patients. Only selected examples of large-scale clinical trials, both short and long term, are addressed. Clinical Trials on the Protective Effect of Platelet-Active Drugs Platelet-active drugs, such as