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Secondary prevention target achievement after myocardial infarction among women and men with and without diabetes: a population-based study

Session Poster Session 2

Speaker Laila Hopstock

Congress : ESC Preventive Cardiology (Formerly EuroPrevent) 2019

  • Topic : preventive cardiology
  • Sub-topic : Secondary Prevention
  • Session type : Poster Session
  • FP Number : P531

Authors : L Hopstock (Tromso,NO), PL Langholz (Tromso,NO), S Grimsgaard (Tromso,NO), ML Lochen (Tromso,NO), I Njolstad (Tromso,NO)

Authors:
L Hopstock1 , PL Langholz1 , S Grimsgaard1 , ML Lochen1 , I Njolstad1 , 1UiT The Arctic University of Norway, Department of Community Medicine - Tromso - Norway ,

Citation:

Background: Despite the known advantages of secondary prevention after myocardial infarction and current emphasis on use of guidelines, treatment targets are frequently not achieved, increasing the risk of recurrent cardiovascular events. Patients with diabetes mellitus are at particular high risk of cardiovascular disease progression and premature death. Thus, there is a need for investigating post myocardial infarction treatment target achievement among patients with diabetes.

Purpose: To investigate treatment target achievement after myocardial infarction among women and men with and without diabetes, using a population-based sample.

Methods: Among 21083 participants from a cross-sectional population survey conducted in 2015-16 (participation rate 65%), 157 women and 539 men aged 40-95 years reported prevalent myocardial infarction, and among these the diabetes prevalence was 16% in both sexes. We investigated post myocardial infarction medication use, smoking, body mass index, physical activity, blood pressure-, serum LDL cholesterol- and HbA1c levels in women and men in two age groups (40-64 and 65+ years) according to current guidelines for secondary prevention of myocardial infarction, in groups of diabetes status, with chi-square test for differences between groups.

Results: In total, prevalence of non-smoking, body mass index<25 kg/m2 and leisure-time physical activity>sedentary was 87% and 88%, 14% and 21%, and 66% and 82%, among the diabetic and non-diabetic participants, respectively. Further, 35% of the diabetic and 62% of the non-diabetic participants had blood pressure levels below 130/80 mmHg and 140/90 mmHg, respectively. LDL cholesterol below 1.8 mmol/L was found in 14% and 10% of the diabetic and non-diabetic participants, respectively. A total of 77% and 64% used antihypertensives, and 90% and 88% used lipid-lowering drugs, among the diabetic and non-diabetic participants, respectively. Among the diabetic participants, 56% had HbA1c levels below 7.5%, and 85.5% used antidiabetics. Statistically significant differences among diabetic and non-diabetic participants were found for blood pressure (p<0.001), physical activity (p<0.001) and use of antihypertensives (p=0.008), and results were similar in both sexes and age-groups.

Conclusions: In this population-based sample, we found secondary prevention of myocardial infarction to be suboptimal in both diabetic and non-diabetic participants.



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