14 ABSTRACT BACKGROUND Coronary heart disease (CHD) is the most common cause of death globally, and clinical guidelines recommend cardioprotective medications for patients with established CHD. Suboptimal use of these medications has been reported, but information from South America is scarce. METHODS We conducted a systematic review on prevalence of secondary prevention medication in South America. We pooled prevalence estimates, analysed time-trends and guideline compliance, and identified factors associated with medication use with meta-regression models. RESULTS Seventy-three publications were included. Medication prevalence varied by class: betablockers 73.4% (95%CI 66.8%–79.1%), ACEI/ARBs 55.8%(95%CI 49.7%–61.8), antiplatelets 84.6%(95%CI 79.6%–88.5%), aspirin 85.1%(95%CI 79.7%–89.3%) and statins 78.9%(95%CI 71.2%–84.9%). The use of beta-blockers, ACEI/ARBs and statins increased since 1993. Ten publications reported low medication use and nine reported adequate use. Medication use was lower in community, public and rehabilitation settings compared to tertiary centres. CONCLUSION Cardioprotective medication use has increased, but could be further improved particularly in community settings. KEYWORDS Coronary heart disease, secondary prevention, South America, time-trends, meta-analysis
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