Key result
During a mean 4.7-year follow-up of chronic CHD patients, low physical activity increased from 53% to 58% (p<0.001), while high-intensity statin use increased from 49% to 54% (p<0.001).
Why the study?
Longitudinal changes in lifestyle behaviour and lipid management over long-term follow-up in a chronic coronary heart disease population remained to be determined.
Cohort (n=1,127)
Yes
Long-term follow-up of coronary outpatients reveals persistent suboptimal risk factor control, highlighting the need for intensified secondary prevention efforts including lifestyle and psychological health management.
Persistent suboptimal risk factor control in chronic CHD outpatients supports intensified secondary prevention; leaves open optimal long-term strategies.
Objective. To determine longitudinal changes in lifestyle behaviour and lipid management in a chronic coronary heart disease (CHD) population. Design. A multi-centre cohort study consecutively included 1127 patients at baseline in 2014–2015, on average 16 months after a CHD event. Data were collected from hospital records, a questionnaire and clinical examination. Seven hundred and seven of 1021 eligible patients participated in a questionnaire-based follow-up in 2019. Data were analysed with univariate statistics. Results. After a mean follow-up of 4.7 years (SD 0.4) from baseline, the percentage of current smokers (15% versus 16%), obesity (23% versus 25%) and clinically significant symptoms of anxiety (21% versus 17%) and depression (13% versus 14%) remained unchanged, whereas the proportion with low physical activity increased from 53% to 58% (p < .001). The proportions with reduced physical activity level were similar in patients over and under 70 years of age. Most patients were still taking statins (94% versus 92%) and more patients used high-intensity statin (49% versus 54%, p < .001) and ezetimibe (5% versus 15%, p < .001) at follow-up. 73% reported ≥1 primary-care consultation(s) for CHD during the last year while 27% reported no such follow-up. There were more smokers among participants not attending primary-care consultations compared to those attending (19% versus 14%, p = .026). No differences were found for other risk factors. Conclusions. We found persistent suboptimal risk factor control in coronary outpatients during long-term follow-up. Closer follow-up and intensified risk management including lifestyle and psychological health are needed to improved secondary prevention and outcome of CHD. Trial registration: Registered at ClinicalTrials.gov: NCT02309255.Registered at 5 December 2014, registered retrospectively.
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Sverre et al. (2020) conducted a cohort in chronic coronary heart disease (CHD) (n=1,127). Time post-CHD event vs. Baseline was evaluated on Longitudinal changes in lifestyle behaviour and lipid management. During a mean 4.7-year follow-up of chronic CHD patients, low physical activity increased from 53% to 58% (p<0.001), while high-intensity statin use increased from 49% to 54% (p<0.001).
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