Secondary prevention
Secondary prevention of cardiovascular disease involves interventions shown to reduce cardiovascular risk and improve long term prognosis.
Patients should be counselled that a diagnosis of stable angina does not automatically mean they will suffer further cardiovascular events such as an MI.
Reducing risk factors for CVD will reduce the risk of further CV events. A patient diagnosed with angina who is otherwise healthy, does not smoke, drink excessively and is physically fit will have a better long term prognosis than a patient of the same age who smokes, drinks and leads a sedentary lifestyle.12
A comprehensive discussion of the risk factors for CVD and advice that can be provided or action that can be taken is found in the Pharmacy Excellence module 'Cardiovascular disease: risk assessment'.
It is important that patients understand that medicines are prescribed for both treatment and prevention of angina symptoms and also to reduce the risk of other cardiovascular events such as a myocardial infarction, arrhythmia or stroke.2
Drugs used to reduce risk are typically antiplatelet agents such as aspirin or clopidogrel or lipid lowering agents such as statins.
NICE guidelines also advise that ACE inhibitors should be considered for patients diagnosed with both stable angina and diabetes.2
Secondary prevention will also involve the use of additional strategies to reduce cardiovascular risk such as controlling blood pressure and blood glucose in patients with diabetes.