ABSTRACT
Ischaemic heart disease (IHD) is characterised by ischaemia to the heart muscle due to coronary artery disease. IHD may be present with angina pectoris, unstable angina, acute coronary syndrome or myocardial infarction. Variation in coronary heart disease (CHD) mortality is largely caused by factors such as housing, education and employment. CHD plus depression is a dangerous combination. It triples the risk of death. Aspirin's beneficial effect in secondary prevention far outweighs the risk of major bleeding. Aspirin should be continued indefinitely at a dose of 75-150 mg. The general practitioners Research Database has shown a low beta blocker use in IHD patients. Cardio-selective beta blockers with associated vasodilator properties, such as Bisoprolol, Metoprolol or Carvedilol, should be used if there is associated heart failure. Run a computer search of patients either at risk or with established osteoporosis who are prescribed calcium supplements - many of these could be elderly women who may also be at high risk of cardiovascular disease.
