Risk factor management in diabetic and non-diabetic patients with coronary heart disease. Findings from the EUROASPIRE I AND II surveys.
OBJECTIVE
We examined risk factor management in diabetic and non-diabetic patients with CHD based on data from EUROASPIRE surveys.


METHODS
Consecutive CHD patients aged 70 years or younger were interviewed and examined at least 6 months after hospitalisation for a revascularisation procedure or acute myocardial infarction or ischaemia. Of these patients, 3569 were from the EUROASPIRE I study, undertaken from 1995 to 1996 in nine countries, and 5556 were from the EUROASPIRE II study, conducted between 1999 and 2000 in 15 countries.


RESULTS
In EUROASPIRE I and II 18% and 20% of CHD patients respectively had been previously diagnosed with diabetes. Fasting glucose screening raised the prevalence of diabetes in EUROASPIRE II to 28%. In EUROSPIRE II the prevalence of risk factors (known diabetic/non-diabetic) was: current smoking 17%/22 % ( p=0.25); obesity (BMI >/=30 kg/m(2)) 43%/29% ( p<0.001); raised blood pressure (>/=140/90 mm Hg) 57%/49% ( p<0.001); and elevated total cholesterol (>/=5.0 mmol/l) 55%/59% ( p<0.001). The proportion of users of cardiovascular medication was: antiplatelet drugs 83%/86% (NS); beta-blockers 62%/63% (NS); ACE inhibitors 49%/35% ( p<0.001); and lipid-lowering drugs 62%/61% (NS). A comparison of both studies showed that for diabetic and non-diabetic patients the prevalence of smoking had increased somewhat and that the prevalence of obesity had increased clearly. There was no improvement in blood pressure control, but cholesterol control had improved, mainly explained by the increased use of lipid-lowering drugs.


CONCLUSIONS
These European surveys show a high prevalence of adverse lifestyles and modifiable risk factors among diabetic and non-diabetic patients with CHD. The risk factor status was more adverse in diabetic patients.
Pyörälä
K
K
Department of Medicine, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland. kalevi.pyorala@uku.fi.
Lehto
S
S
Department of Medicine, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland.
De Bacquer
D
D
Department of Public Health, University of Ghent, Ghent, Belgium.
De Sutter
J
J
Department of Public Health, University of Ghent, Ghent, Belgium.
Sans
S
S
Department of Health and Social Security, Institute of Health Studies, Barcelona, Spain.
Keil
U
U
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Wood
D
D
Cardiovascular Medicine, National Heart and Lung Institute, Imperial College School of Medicine at Charing Cross Campus, London, UK.
De Backer
G
G
Department of Public Health, University of Ghent, Ghent, Belgium.
D000368:Aged; D015992:Body Mass Index; D003327:Coronary Disease / Q000453:epidemiology* / Q000628:therapy; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000628:therapy; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors