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.