Secondary prevention and associated drug therapy.
In secondary prevention, the treatment of serious disorders is undoubtedly necessary. This applies to the treatment of latent or manifest heart failure with digitalis glycosides, the treatment of coronary insufficiency with suitably active medicaments, and the administration of antiarrhythmics to patients with cardiac arrhythmias, who could be particularly endangered under certain circumstances. Raised arterial blood pressure, one of the most important risk factors of coronary heart disease, requires suitable drug treatment. Similarly, the additional administration of medicaments that affect lipid metabolism and of substances that lower raised uric acid levels together with a suitable diet is often inevitable. It is patently obvious that diabetes mellitus must be optimally controlled. Whether the long-term administration of beta-sympatholytics has a protective effect on the onset of sudden deaths through cardiac arrhythmias or on the incidence of reinfarction is, in the present state of knowledge, quite possible, but still not definitely proven. Different indications and dosages of the medicament, and thus the absence of standardized conditions, scarcely permit an assessment of the success of associated drug therapy in secondary prevention.