Abstract:
Among the 330 incident cases of MI studied, there was preponderance of males. The mean
age at presentation was 57.4 (SD 12.0). Among thy males, 75 percent belonged to the ever
smoker category and 41 percent were current smokers at the time of developing the index
cardiac event. Lipid abnormalities were common among acute MI cases with two thirds of
the cases! having a serum LDL cholesterol concentration 100 mg/dl. Some form of lipid
abnormality persisted at the time of developing the acute MI in nearly half of those already
on lipid lowering drug. The prevalence of diabetes mellitus among incident MI cases was
clearly in excess of the population prevalence of the disease, with a self reported prevalence
of 28 percent among males and 49 percent among females. Blood glucose control was I
poor ( 125 mg/dl) in 65 percent of those who reported having diabetes mellitus prior to the
index event. The prevalence of overweight ranged from 25 percent to 87 percent de ending
on the indicator used. The majority of the incident MI cases were physically active prior to
the index event with only 26 percent 0f cases reporting low physical activity levels. In the
second component of the study, a cardiac rehabilitation programme was implemented on a
selected group of patients. At six months following the index major cardiac event, risk
modification in this group was compared with another group of patients who did not
undergo rehabilitation. A quasi-experimental study design using a. pre-test post-test design
was used to evaluate the CRP. Ninety one I percent of those who participated in the CRP
and 7 percent 5 percent of the controls were followed up at six months. Those who were lost
to followed up at six months. Those who were similar in socio-demographic and baseline
clinical risk profiles in both groups except for marital status and plasma glucose
concentrations among the control group There were significant changes in the risk profiles
at six months in both groups when each grouP1as taken separately. However, the absolute
changes in risk modification were seen 0 y with regard to serum LDL cholesterol, quality of
diet, physical activity levels and smoking status. In multivariate models, attending the CRP
was a significant independent predictor of absolute change in serum LDL cholesterol,
quality of diet and physical activity levels, irrespective of the individual's sociodemographic milieu. Smoking cessation, better control of lipid and glucose levels in those
who already have high levels, controlling the increasing trends in obesity and empowering
the females who are at high risk are recommended in controlling the epidemic of CHD.
Implementing CRPs in other settings and strengthening "usual" care received at clinics, as at
percent, are recommended in the secondary prevention of CHD through behaviour risk
modification.