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Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries

K Kotseva, D Wood, Backer G De, Bacquer D De, K Pyorala, U Keil, Study Group EUROASPIRE

. 2009 ; 373 (9667) : 929-940.

Language English Country Great Britain

Document type Comparative Study, Research Support, Non-U.S. Gov't

Grant support
NR9333 MZ0 CEP Register

Digital library NLK
Full text - Část
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E-resources Online Full text

NLK ProQuest Central from 1992-01-04 to 3 months ago
Nursing & Allied Health Database (ProQuest) from 1992-01-04 to 3 months ago
Health & Medicine (ProQuest) from 1992-01-04 to 3 months ago
Family Health Database (ProQuest) from 1992-01-04 to 3 months ago
Psychology Database (ProQuest) from 1992-01-04 to 3 months ago
Health Management Database (ProQuest) from 1992-01-04 to 3 months ago
Public Health Database (ProQuest) from 1992-01-04 to 3 months ago
ScienceDirect (archiv) from 1993-01-01 to 2009-12-31

BACKGROUND: The first and second EUROASPIRE surveys showed high rates of modifiable cardiovascular risk factors in patients with coronary heart disease. The third EUROASPIRE survey was done in 2006-07 in 22 countries to see whether preventive cardiology had improved and if the Joint European Societies' recommendations on cardiovascular disease prevention are being followed in clinical practice. METHODS: EUROASPIRE I, II, and III were designed as cross-sectional studies and included the same selected geographical areas and hospitals in the Czech Republic, Finland, France, Germany, Hungary, Italy, the Netherlands, and Slovenia. Consecutive patients (men and women /=30 kg/m(2)) increased from 25.0% in EUROASPIRE I, to 32.6% in II, and 38.0% in III (p=0.0006). The proportion of patients with raised blood pressure (>/=140/90 mm Hg in patients without diabetes or >/=130/80 mm Hg in patients with diabetes) was similar (58.1% in EUROASPIRE I, 58.3% in II, and 60.9% in III; p=0.49), whereas the proportion with raised total cholesterol (>/=4.5 mmol/L) decreased, from 94.5% in EUROASPIRE I to 76.7% in II, and 46.2% in III (p<0.0001). The frequency of self-reported diabetes mellitus increased, from 17.4%, to 20.1%, and 28.0% (p=0.004). INTERPRETATION: These time trends show a compelling need for more effective lifestyle management of patients with coronary heart disease. Despite a substantial increase in antihypertensive and lipid-lowering drugs, blood pressure management remained unchanged, and almost half of all patients remain above the recommended lipid targets. To salvage the acutely ischaemic myocardium without addressing the underlying causes of the disease is futile; we need to invest in prevention.

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$a Kotseva, Kornelia $u Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
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$a BACKGROUND: The first and second EUROASPIRE surveys showed high rates of modifiable cardiovascular risk factors in patients with coronary heart disease. The third EUROASPIRE survey was done in 2006-07 in 22 countries to see whether preventive cardiology had improved and if the Joint European Societies' recommendations on cardiovascular disease prevention are being followed in clinical practice. METHODS: EUROASPIRE I, II, and III were designed as cross-sectional studies and included the same selected geographical areas and hospitals in the Czech Republic, Finland, France, Germany, Hungary, Italy, the Netherlands, and Slovenia. Consecutive patients (men and women </=70 years) were identified after coronary artery bypass graft or percutaneous coronary intervention, or a hospital admission with acute myocardial infarction or ischaemia, and were interviewed at least 6 months later. FINDINGS: 3180 patients were interviewed in the first survey, 2975 in the second, and 2392 in the third. Overall, the proportion of patients who smoke has remained nearly the same (20.3% in EUROASPIRE I, 21.2% in II, and 18.2% in III; comparison of all surveys p=0.64), but the proportion of women smokers aged less than 50 years has increased. The frequency of obesity (body-mass index >/=30 kg/m(2)) increased from 25.0% in EUROASPIRE I, to 32.6% in II, and 38.0% in III (p=0.0006). The proportion of patients with raised blood pressure (>/=140/90 mm Hg in patients without diabetes or >/=130/80 mm Hg in patients with diabetes) was similar (58.1% in EUROASPIRE I, 58.3% in II, and 60.9% in III; p=0.49), whereas the proportion with raised total cholesterol (>/=4.5 mmol/L) decreased, from 94.5% in EUROASPIRE I to 76.7% in II, and 46.2% in III (p<0.0001). The frequency of self-reported diabetes mellitus increased, from 17.4%, to 20.1%, and 28.0% (p=0.004). INTERPRETATION: These time trends show a compelling need for more effective lifestyle management of patients with coronary heart disease. Despite a substantial increase in antihypertensive and lipid-lowering drugs, blood pressure management remained unchanged, and almost half of all patients remain above the recommended lipid targets. To salvage the acutely ischaemic myocardium without addressing the underlying causes of the disease is futile; we need to invest in prevention.
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$a Hrbková, Jana. $7 _BN005084 $u Charles University, Medical Faculty, Pilsen
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$a Patraulea, Monica. $7 xx0243767 $u Charles University, Medical Faculty, Pilsen
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$a Hrnčárek, Marek, $d 1966- $7 xx0077273 $u Department of Preventive Cardiology, Institute of Clinical Experimental Medicine, Prague
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$a Lupínek, Petr, $d 1965- $7 xx0057868 $u Department of Preventive Cardiology, Institute of Clinical Experimental Medicine, Prague
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$a Plasková, M. $u Department of Preventive Cardiology, Institute of Clinical Experimental Medicine, Prague
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$a Škodová, Zdenka $7 xx0153069 $u Department of Preventive Cardiology, Institute of Clinical Experimental Medicine, Prague
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$a Cífková, Renata, $d 1955- $7 nlk20010094490 $u Department of Preventive Cardiology, Institute of Clinical Experimental Medicine, Prague
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