A survey of control of major risk factors following coronary artery bypass graft surgery

The aim of this survey was to review the awareness and efficacy amongst patients and general practitioners (GPs) in controlling coronary risk factors following coronary artery bypass graft surgery (CABG). It was a prospective cohort study based on an inclusive registry at our department 230 patients who underwent CABG between April 1999–July 2000 and who had a history of hypertension and hypercholesterolaemia were selected. Frequency of blood pressure (BP) and cholesterol monitoring, blood glucose control, current smoking status, weight and medications were established via telephone interview of patients. BP and cholesterol levels were confirmed by written questionnaires to GPs. BP and cholesterol were considered to be controlled if they were ≤ 140/85 mmHg and ≤ 5.0 mmol/L respectively. Of the 230 patients, 213 were successfully contacted. After surgery, 181 (85%) patients had BP checks at least six-monthly by their GPs, 13 (6.1%) less frequently and 19 (8.9%) not at all. Cholesterol levels were checked at least six-monthly in 128 (60.1%), less frequently in 47 (22.1%) and not at all in 38 (17.8%). Thirteen of the 20 patients who were smoking at the time of surgery continued to smoke. BP and cholesterol readings were obtained for 169 of the 213 patients. Of these, BP was well controlled in 92 (54.4%), uncontrolled in 61 (36.1%) and not checked in 16 (9.5%). Cholesterol was well controlled in 106 (62.7%), uncontrolled in 35 (20.7%) and not checked in 28 (16.6%) patients. Although patients and GPs are generally aware of the importance of controlling coronary disease risk factors, more effort is required if we are to meet the Joint British recommendations on prevention of coronary heart disease.