The secondary prevention of cardiovascular disease

Abstract Observational studies and clinical trials have shown that lower levels of risk factors in patients with established cardiovascular disease (CVD) can substantially reduce their risk of suffering recurrent vascular events. Efforts directed towards reducing further CV events in patients with established CVD are known as secondary prevention. This chapter reviews the epidemiological evidence for risk factor control, lifestyle changes, and medical strategies in the secondary prevention setting. Mainstays of secondary prevention include attention to blood pressure lowering, glucose control, tobacco cessation, and optimizing an individual's cholesterol using proven medical therapies, together with sound dietary and physical activity programs, and regular use of antiplatelet agents.