[Secondary prevention of coronary heart disease].

The target group for "secondary prevention"--better "risk-adapted prevention"--of CHD are individuals who have suffered a myocardial infarction or have indicator diseases or other risk factor constellations with a cardiovascular risk of > 20% in ten years. The indisputably effective measures include cessation of smoking, blood pressure control with appropriate medications, a Mediterranean diet, maritime omega-3 fatty acids, endurance sports, statin-based lipid management (LDL < 100 mg/dl, triglycerides < 200 mg/dl), a target BMI of 18.5-25, optimized diabetes management, use of platelet aggregation inhibitors, beta blockers and ACE inhibitors. Hormone replacement therapy or vitamin supplementation has been identified as ineffective or mildly dangerous. Other measures have either not become established, or only poorly so. Currently, implementation of the effective measures leaves much to be desired. Quality-controlled close cooperation by the family doctor and cardiologist arguably provides the best long-term care in the area of secondary prevention, but still remains utopian.