Prevention

Cholesterol

Lower cholesterol levels ^a even for patients with average levels (cholesterol 4.0 mmol/l to 6.2 mmol/l) ^a using 

• diet modification: ^a encourage patients to eat less fat ^a (particularly cholesterol) ^a  and more oats ^a, fish ^a and soy protein. ^b
• a statin ^a, particularly to patients revascularised following post-infarct angina. ^a  
• gemfibrozil for patients with low HDL levels ^a
• garlic ^a

There is no clear benefit from referring your patient to a dietician - self-help material is equally effective. ^a  

Diet

Consider giving patients vitamin E supplements (alpha-tocopherol) ^a

Hypertension

Treat hypertension ^a

Encourage patients to stop smoking ^a, and ask nurses ^a and other staff  ^a to provide further advice.

Offer buproprion ^a

Alternatives include

• nicotine replacement therapy - a combination works best (e.g. patches ^a and gum ^a ) 
• nortryptiline ^a
• clonidine - but adverse effects are common ^a 

Arrange for self-help material and follow-up advice after discharge, with personalised feedback. ^a

Alternatives include

• individual counselling ^a 
• telephone-based counselling ^b 

There is no clear benefit from 

• a exercise programme.   ^a 
• anxiolytics    ^a 
• silver acetate  ^d

Exercise

Offer an exercise rehabilitation programme. ^a

There is no clear benefit from giving postmenopausal women oestrogen and progestin ^d