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Eur J Prev Cardiol. 2016 Apr;23(6):636-48. doi: 10.1177/2047487315569401. Epub 2015 Feb 16.

EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries.

Author information

1
The European Society of Cardiology, Sophia Antipolis Cedex, France International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, UK k.kotseva@imperial.ac.uk.
2
The European Society of Cardiology, Sophia Antipolis Cedex, France International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, UK.
3
The European Society of Cardiology, Sophia Antipolis Cedex, France Department of Public Health, University of Ghent, Belgium.
4
The European Society of Cardiology, Sophia Antipolis Cedex, France Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
5
Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
6
Institut Pasteur de Lille, Université de Lille, France.
7
The European Society of Cardiology, Sophia Antipolis Cedex, France Centre for Cardiovascular Prevention, 1st Medical Faculty Charles University and Thomayer Hospital, Prague, Czech Republic.
8
Cardiac Rehabilitation Unit, Cardiology Department, Hospital Universitario La Paz, Madrid, Spain.
9
The European Society of Cardiology, Sophia Antipolis Cedex, France Thoraxcentre's Department of Cardiology, Rotterdam, The Netherlands.
10
The European Society of Cardiology, Sophia Antipolis Cedex, France Department of Internal Medicine, University of Ghent, Belgium.
11
The European Society of Cardiology, Sophia Antipolis Cedex, France Clinical Centre University of Sarajevo, Bosnia and Herzegovina.
12
Department of Cardiology, Shupyk's National Medical Academy of Postgraduate Education, Kiev, Ukraine.
13
The European Society of Cardiology, Sophia Antipolis Cedex, France University of Latvia, Pauls Stradins Clinical University Hospital, Riga, Latvia.
14
The European Society of Cardiology, Sophia Antipolis Cedex, France University Medical Centre, Ljubljana, Slovenia.
15
The European Society of Cardiology, Sophia Antipolis Cedex, France Universitatea de Medicina si Farmacie 'Victor Babes', Institutul de Boli Cardiovasculare, Timisoara, Romania.
16
Department of Cardiology, National Heart Hospital, Sofia, Bulgaria.
17
The European Society of Cardiology, Sophia Antipolis Cedex, France Cardiology Department of Medical School University of Ioannina, Greece.
18
Institute of Clinical Epidemiology and Biometry, University of Würzburg; Comprehensive Heart Failure Centre, University of Würzburg; Clinical Trial Centre Würzburg, University Hospital Würzburg, Germany.
19
The European Society of Cardiology, Sophia Antipolis Cedex, France Clinic of Cardiovascular Diseases of Vilnius University; Heart and Vascular Medicine of Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania.
20
Kuopio University Hospital, Finland.
21
The European Society of Cardiology, Sophia Antipolis Cedex, France Clinic for Internal Medicine Intermedica, Nis, Serbia.
22
The European Society of Cardiology, Sophia Antipolis Cedex, France University of Zagreb School of Medicine & University Hospital Centre Zagreb, Croatia.
23
The Adelaide and Meath Hospital, Dublin, Ireland.
24
The European Society of Cardiology, Sophia Antipolis Cedex, France University of Nicosia Medical School, Nicosia General Hospital, Cyprus.
25
National Research Centre for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.
26
Jagiellonian University Medical College, Faculty of Health Sciences, Department of Epidemiology and Population Studies, Kracow, Poland.
27
The European Society of Cardiology, Sophia Antipolis Cedex, France Federal Health Centre and Department of Chronic Noncommunicable Diseases Prevention, National Research Centre for Preventive Medicine, Moscow, Russia.
28
The European Society of Cardiology, Sophia Antipolis Cedex, France University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia.
29
Department of Heart Failure and Valve Disease, Skåne University Hospital, Lund, Sweden.
30
Comprehensive Heart Failure Centre and Department of Medicine I, University of Würzburg, Germany.
31
The European Society of Cardiology, Sophia Antipolis Cedex, France Hacettepe University, Ankara, Turkey.
32
The European Society of Cardiology, Sophia Antipolis Cedex, France Centre for Medical Research, School of Medicine, University of Banja Luka, Bosnia and Herzegovina.

Abstract

AIMS:

To determine whether the Joint European Societies guidelines on cardiovascular prevention are being followed in everyday clinical practice of secondary prevention and to describe the lifestyle, risk factor and therapeutic management of coronary patients across Europe.

METHODS AND RESULTS:

EUROASPIRE IV was a cross-sectional study undertaken at 78 centres from 24 European countries. Patients <80 years with coronary disease who had coronary artery bypass graft, percutaneous coronary intervention or an acute coronary syndrome were identified from hospital records and interviewed and examined ≥ 6 months later. A total of 16,426 medical records were reviewed and 7998 patients (24.4% females) interviewed. At interview, 16.0% of patients smoked cigarettes, and 48.6% of those smoking at the time of the event were persistent smokers. Little or no physical activity was reported by 59.9%; 37.6% were obese (BMI ≥ 30 kg/m(2)) and 58.2% centrally obese (waist circumference ≥ 102 cm in men or ≥88 cm in women); 42.7% had blood pressure ≥ 140/90 mmHg (≥140/80 in people with diabetes); 80.5% had low-density lipoprotein cholesterol ≥ 1.8 mmol/l and 26.8% reported having diabetes. Cardioprotective medication was: anti-platelets 93.8%; beta-blockers 82.6%; angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75.1%; and statins 85.7%. Of the patients 50.7% were advised to participate in a cardiac rehabilitation programme and 81.3% of those advised attended at least one-half of the sessions.

CONCLUSION:

A large majority of coronary patients do not achieve the guideline standards for secondary prevention with high prevalences of persistent smoking, unhealthy diets, physical inactivity and consequently most patients are overweight or obese with a high prevalence of diabetes. Risk factor control is inadequate despite high reported use of medications and there are large variations in secondary prevention practice between centres. Less than one-half of the coronary patients access cardiac prevention and rehabilitation programmes. All coronary and vascular patients require a modern preventive cardiology programme, appropriately adapted to medical and cultural settings in each country, to achieve healthier lifestyles, better risk factor control and adherence with cardioprotective medications.

KEYWORDS:

EUROASPIRE; cardiovascular prevention; guidelines; rehabilitation

PMID:
25687109
DOI:
10.1177/2047487315569401
[Indexed for MEDLINE]
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