Abstract
OBJECTIVE: To describe the use of ischaemic heart disease (IHD) secondary prevention measures in the Spanish National Health System. DESIGN: Systematic review of observational studies with information on the use of preventive treatment and measures in the prevention of secondary IHD. SETTING: Primary care and specialised out-patient clinics. DATA SOURCES: Medline search and complementary searches of studies published between 1995 and 2004 with a description of the use secondary prevention measures on hospital discharge or in the follow up after discharge. SELECTION OF STUDIES: A total of 125 references were found after the MEDLINE search, 13 of which were selected after an independent review by 2 researchers. The complementary sources provided 9 more studies giving a total of 22. DATA EXTRACTION: One researcher extracted information on the characteristics of the study and the results variables, which were independently verified by a second evaluator. RESULTS. In the 22 studies found, a high level of variation was shown in the different treatment rates: anti-aggregants (at discharge, 72%-97.1%; follow-up, 46.4%-93.8%); beta-blockers (at discharge, 29%-68.3%; follow-up, 22.4%-59.0%); drugs with action on the renin-angiotensin system (at discharge, 16.2%-52.2%; follow-up, 6.1%-53.1%); lipid lowering drugs (at discharge, 6.7%-88.7%; follow-up, 24.5%-89.5%). The treatment rates showed a progressive improvement over time during the period studied. CONCLUSIONS: In the period 1994-2003 treatment rates in the secondary prevention of IHD have increased, although there is still much room for improvement.