Læknablaðið - 15.06.1999, Page 10

510
LÆKNABLAÐIÐ 1999; 85
Lyfjameðferð kransæðasjúklinga
á íslandi
Emil L. Sigurðsson'2, Jón Steinar Jónsson3, Guðmundur Þorgeirsson4
Sigurðsson EL, Jónsson JS, Þorgeirsson G
Medical treatment of coronary heart disease in
Iceland
Læknablaðið 1999; 85: 510-5
Objective: During the last decades the knowledge of
prevention of coronary heart disease (CHD) has in-
creased dramatically. Results from large clinical trials
on drug treatment of patients with CHD with various
groups of drugs has given new possibilities to im-
prove the prognosis of our patients. However, results
from several studies have shown that this knowledge
has not yet been put into practice. The main aim of
our study, which is a part of a larger enquiry into the
actual practice of secondary prevention of CHD in
Iceland, was to evaluate the medical treatment of
CHD, other than lipid lowering therapy.
Material and methods: All patients with residence
in Hafnarfjörður, Garðabær and Bessastaðahreppur
who have been diagnosed as having CHD were sent
a letter with an invitation to participate in the study
and a request for an informed consent. Those who
choose to participate responded to a questionnaire
and gave a permission for a review of their records
with respect to a specific diagnosis and lipid values.
The patients were divided into four groups on the
basis of their history: I. myocardial infarction (MI),
II. coronary artery bypass surgery (CABG), III. per-
cutaneous transiluminal coronary angioplasty
(PTCA) and IV. angina pectoris (AP). If a patient ful-
filled the critera for more than one diagnostic group
the CABG group had the highest priority followed by
PTCA, MI and finally AP.
Frá ’Heilsugæslustöðinni Sólvangi, Hafnarfirði, 2heimilis-
læknisfræði Háskóla íslands, 3Heilsugæslunni í Garðabæ,
lyflækningadeild Landspítalans. Fyrirspurnir, bréfaskipti:
Emil L. Sigurðsson, Heilsugæslustöðinni Sólvangi, 220
Hafnarfirði.
Lykilorð: kransæðasjúkdómur, meðferð, forvarnir.
Results: A total of 533 patients with CHD were
living in the study area and of those 402 (75%) parti-
cipated in the study. Aspirin was used by 284 patients
(71%), 75% among men and 65% among women
(p=0.0I8). The highest proportion (91%) being
among those who had undergone CABG, and the
lowest among those with angina pectoris (56%). Half
of the patients (52%) used beta blockers and 119
(30%) diuretics. A total of 172 patients received
treatment with nitrates (43%), 57% of the women
and 27% of the men (p=0.006). Calcium blockers
were used by 145 patients (36%) and ACE inhibitors
by 81 (20%). Among women in the age group 40 to
80 years, 16% were receiving hormone replacement
therapy.
Conclusions: These results indicate that in Iceland,
as in many other countries, secondary prevention of
CHD is not beeing fully implemented and the
scientific evidence that has been obtained from large
clinical trials, has not yet been put into practice.
There is obviously a great potential to improve the
medical treatment and prognosis of our patients with
CHD.
Key words: coronary heart disease, treatment, prevention.
Ágrip
Tilgangur: A síðustu áratugum hefur þekk-
ingu manna á forvörnum hjarta- og æðasjúk-
dóma fleygt fram. Niðurstöður stórra klínískra
rannsókna á lyfjameðferð kransæðasjúklinga
með ýmsum lyfjaflokkum hafa leitt af sér nýja
möguleika til þess að hafa áhrif á horfur sjúk-
linga með kransæðasjúkdóm. Rannsóknir er-
lendis frá hafa þó sýnt að þessi þekking er enn
ekki nýtt sem skyldi. Tilgangur þessarar rann-
sóknar, sem er hluti af stærri rannsókn á með-
ferð og eftirliti sjúklinga með kransæðasjúk-
dóm á Islandi, var að kanna hvernig lyfjameð-
ferð kransæðasjúklinpa, annarri en blóðfitu-
lækkandi, er háttað á Islandi.