Challenges in coronary heart disease prevention – experiences from a long-term follow-up study in Norway

<i>Objective.</i> To determine longitudinal changes in lifestyle behaviour and lipid management in a chronic coronary heart disease (CHD) population. <i>Design.</i> A multi-centre cohort study consecutively included 1127 patients at baseline in 2014–2015, on average 16 months after a CHD event. Data were collected from hospital records, a questionnaire and clinical examination. Seven hundred and seven of 1021 eligible patients participated in a questionnaire-based follow-up in 2019. Data were analysed with univariate statistics. <i>Results.</i> After a mean follow-up of 4.7 years (SD 0.4) from baseline, the percentage of current smokers (15% versus 16%), obesity (23% versus 25%) and clinically significant symptoms of anxiety (21% versus 17%) and depression (13% versus 14%) remained unchanged, whereas the proportion with low physical activity increased from 53% to 58% (<i>p</i> p p p = .026). No differences were found for other risk factors. <i>Conclusions.</i> We found persistent suboptimal risk factor control in coronary outpatients during long-term follow-up. Closer follow-up and intensified risk management including lifestyle and psychological health are needed to improved secondary prevention and outcome of CHD. <b>Trial registration:</b> Registered at ClinicalTrials.gov: NCT02309255. Registered at 5 December 2014, registered retrospectively.