What are "Secondary Prevention Targets" and why are they significant?

From - Rouge Valley Health System - Cardiac Rehab Services - Toronto, Ontario
May 2002

In the past, your doctor has assessed your risk of cardiac events (heart attack, stroke) by the assessment of your cardiac risk factors such as high blood pressure, smoking and high cholesterol to name a few. However, we now realize that assessing risk factors alone doesn't tell us the whole story. Risk factors do not completely account for the risk of developing coronary artery disease, and do not accurately predict the annual risk of having a cardiac event.

Large clinical trials have demonstrated that secondary prevention strategies using specific treatment goals may reduce the annual risk of future cardiac events and may actually slow the progression of heart disease.

Secondary prevention strategies include medications that your doctor prescribes for you, as well as lifestyle behaviours. They encompass some of the traditional controllable risk factors previously used such as smoking, blood pressure, cholesterol levels, regular aerobic exercise etc. Failure to achieve the documented targets may reduce your benefit of reducing your cardiac risk.

Some of the medications that your doctor will prescribe, have specific secondary prevention targets or doses. Clinical trials have demonstrated that benefits from the medications are dose specific. For example, the HOPE study demonstrated that Altace 10 mg once a day had a significant reduction in cardiac events for people with known cardiovascular disease or diabetes. There is evidence that reduced doses of these medications may not have the same benefit. For this reason, your doctor will be working with you to try and reach the specified target doses.

Below is a table outlining the secondary prevention targets that you should be working towards. There are many strategies for reaching these targets and your doctor and health care team members will work with you to achieve these targets. You will notice that there is space in this chart for you to write in your current status. If you do not know your current status on these secondary prevention targets, ask your doctor or health care team members.

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