IntroductionEuropean treatment guidelines in persons with known coronary heart disease (CHD) focus on adherence to antiplatelet therapy, β-blockers, ACE/ARBs, and lipid-lowering agents, with goals for blood pressure (BP) of < 140/90 mm Hg and LDL cholesterol of < 3.0 mmol/l. Data on adherence to these measures in Eastern Europe are limited.Material and methodsThe Third Republic of Srpska, Bosnia and Herzegovina, Coronary Prevention Study (ROSCOPS III) was conducted in 2005–2006 at 10 primary heath care centres in 601 patients (36% female, mean age 55 years) with CHD including acute myocardial infarction or ischaemia, coronary artery bypass graft, or angioplasty who were examined and interviewed at least 6 months after the event. We examined the proportion of subjects on recommended treatments and at goal for BP, LDL-C, and non-smoking.ResultsThe proportion of subjects on recommended treatments included 61% for β-blockers, 79% for ACE/ARBs, 63% for lipid-lowering agents and 74% for antiplatelet therapy. Only 30% of subjects were on all four of these treatments. 59% of subjects had BP at goal of < 140/90 mm Hg and 33% were controlled to < 130/80 mm Hg, 41% for LDL-C, and 88% were non-smokers. Improvements were seen in lipid-lowering and ACE/ARB drug use and non-smoking status from an earlier survey (ROSCOPS II) in 2002–2003.ConclusionsOur data show, despite improvement over recent years, that many persons with CHD in the Republic of Srpska, Bosnia and Herzegovina are neither on recommended treatments nor at target for BP and/or LDL-C. Improved efforts targeted at both physicians and patients to address these issues are needed.

The implementation guidelines for prevention of the coronary heart disease are measures which are available to the individuals as well as to the entire population. These measures aim to detect the diseases and to conduct faster and more successful medical intervention. More so, these measures are directed against the progression or relapse of disease in patients with an established disease. The secondary prevention of coronary diseases would include the measures which objective is the prevention of relapse and the progression of atherosclerosis in patients who already have an established coronary disease. The modification of the risk factors is the key part of the secondary prevention of coronary disease. The main risk factors remain the important predictors of the long-term prognosis in patients with a coronary disease. The study on conduction of measures for secondary prevention of coronary disease showed high prevalence of bad lifestyle characteristics, other risk factors and insufficient use of prophylactic drugs in coronary disease patients. Inadequate treatment of risk factors in coronary patients is similar in Europe as well as in the other parts of the world.

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