Box 1: The National Service Framework for Coronary Heart Disease

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The NHS and partner agencies should:

Primary prevention

Reduce the prevalence of coronary risk factors in the population, and reduce inequalities in risks of developing heart disease.

Reduce prevalence of smoking in the local population.

Secondary prevention

Identify and reduce risk in all people with established cardiovascular disease, including those at significant risk but without symptoms.

Acute care

Within 8 minutes of calling for help receive resuscitation when necessary. If indicated, receive aspirin, and thrombolysis within 60 minutes.

Protocols/systems of care should be used in hospitals for patients with proven heart attack.

Angina that is increasing in frequency or severity should be referred to a cardiologist urgently or, for those at greatest risk, as an emergency.

Longer term care

People with angina should receive appropriate investigation and treatment to relieve their pain and reduce their risk of coronary events.

People with suspected heart failure should be investigated and treatments given to both relieve their symptoms and reduce their risk of death.

Rehabilitation

People discharged from hospital following admission for coronary heart disease should be offered a multidisciplinary programme of secondary prevention and cardiac rehabilitation.