OBJECTIVE: Secondary prevention is an important part of cardiovascular risk management. Since 1996, an inventory of cardiovascular risk factors and their treatment has been carried out periodically among patients with coronary heart disease within the framework of the European Action on Secondary Prevention by Intervention to Reduce Events (Euroaspire) project.DESIGN: Retrospective investigation of consecutively hospitalised patients with coronary heart disease.METHOD: Major cardiovascular risk factors and their treatment were investigated using standardised methods in patients who were hospitalised following a first heart infarction or with coronary revascularisation in the Amsterdam and Rijnmond regions of the Netherlands from 2012 to 2013. The investigations were carried out at an average of 18 months after admission. In addition, an oral glucose-tolerance test was carried out in patients without known diabetes.RESULTS: We studied 498 patients. The average BMI was 28 kg/m2, almost 75% had a BMI ≥ 25 kg/m2and 29% had a BMI ≥ 30 kg/m2. The mean cholesterol level was 4.4 mmol/l. Among those included, 16% smoked and 20% had diabetes mellitus; the oral glucose-tolerance test led to a new diabetes-mellitus diagnosis in 1% of the patients without known diabetes. A large majority of those included used antihypertensive agents, and slightly more than half used two or more medications. Despite this, half of the patients were hypertensive.CONCLUSION: As far as cardiovascular risk factors are concerned, smoking has almost halved in the past 20 years. Secondary preventative medication has increased to a stable high level. Blood pressure and overweight continue to be serious points for attention. Treatment of hypertension, in particular, should be improved, for instance by dose increases or combination of hypertensive medications. Routine oral glucose-tolerance tests are not useful in cardiac patients.
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De spilzorger noemen we de mantelzorger die een centrale rol speelt in de zorg en participatie van de persoon met Niet Aangeboren Hersenletsel (NAH) 1. Deze persoon levert niet alleen zorg en ondersteuning maar is ook de poort naar de sociale omgeving en naar (maatschappelijke en/of zingevende) activiteiten. Wanneer deze persoon kortdurend, langdurend of helemaal wegvalt, kan het bestaan van degene met de beperking op losse schroeven komen te staan. Uit ons onderzoek blijkt dat door ongemak van de spilzorger, onmacht van degene met de beperking of handelingsverlegenheid van de professional, onvoldoende ingegaan wordt op wat in een dergelijke situatie wenselijk zou zijn. Wij pleiten er dan ook voor dit bespreekbaar te maken, en een plan te ontwikkelen voor als deze situatie zich onverhoopt zou voordoen. Dit kan voor zowel de spilzorger als de persoon met NAH de nodige geruststelling geven
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