An integrated effort is needed to provide seamless care for patients between hospital and general practice. The use of protocols that are common to both sectors will lead to the best possible outcomes. It seems that secondary prevention may reduce sudden death and the 28-day mortality rate. The evidence base for the drugs used in secondary prevention is derived mostly from hospital trials. The relevant findings for aspirin, beta blockade, statins, ACE inhibitors and oral anticoagulants are discussed. After coronary revascularisation, special care is required if patients are to have a smooth path: both exercise and comprehensive cardiac rehabilitation are valuable.