Treatable risk factors--hypercholesterolemia, smoking, and hypertension--after myocardial infarction: implications of the coronary drug project data for clinical management. Coronary Drug Project Research Group.

Data from the five-year follow-up of the 2789 men in the placebo group of the Coronary Drug Project indicate that serum cholesterol level elevation and cigarette smoking, both remediable factors, adversely affect morbidity and mortality following recovery from myocardial infarction. Although the most powerful predictive factors of mortality from coronary heart disease were those related to the status of the myocardium (selected electrocardiographic changes, cardiomegaly, New York Heart Association functional classification), these features are basically irremediable. These observations suggest that benefit may ensue from measures that can safely reduce elevated serum cholesterol levels or lead to cessation of smoking or both and that use of these two interventions appears prudent in patients recovered from myocardial infarction. Data regarding hypertension are less clear; at present the evidence would suggest that management of mild hypertension following myocardial infarction should give emphasis to sodium restriction and reduction of weight, when appropriate.