In multivariable models adjusted for several patient and physician characteristics, having an LDL < 130 mg/dL was less likely for patients in the oldest age quartile (odds ratio (OR) 0.59, 95% confidence interval 0.49 ± 0.72), female patients (OR 0.60 [0.51 ± 0.69]), those without insurance coverage of medications (OR 0.54 [0.37 ± 0.79]), and those whose type of insurance indicated low socioeconomic status (OR 0.85 [0.70 ± 1.01]). Older patients and women were less likely to have a blood pressure < 140/90 mm Hg. Younger age was of borderline significance in predicting beta-blocker use. CONCLUSION: At outpatient practices affiliated with a major academic medical center, there is still much room for improvement in the secondary prevention of CAD. Deficiencies were greatest in the area of lipid management. Lipid management also was the most susceptible to practice variation on the basis of socioeconomic status. Older patients and women also were less likely to receive adequate secondary prevention. Interventions such as physician education, computerized reminder systems, and population management may be effective in correcting some of these shortcomings.