Treatment potential for cholesterol management in patients with coronary heart disease in 15 European countries: findings from the EUROASPIRE II survey.
BACKGROUND
During the last decade, the evidence of beneficial effects of cholesterol lowering in patients with coronary heart disease (CHD) has been proven in several clinical trials. This has prompted international guidelines on prevention of CHD to include recommendations on dietary and pharmacological treatment of hyperlipidaemia with set goals on total- and LDL-cholesterol.


METHODS
The first EUROASPIRE survey performed in 1995/1996 showed poor adherence to the European recommendations on lipid-lowering in patients with CHD. The second survey was carried out in 1999/2000 in 15 European countries and enrolled 8181 patients with CHD. Medical records were assessed and clinical examinations of risk factors including serum lipids were performed. The aim of this survey is to describe the treatment of hyperlipidaemia among CHD patients in Europe.


RESULTS
The proportion of patients not reaching the target of 5.0mmol/l was 58.3% with significant variations between countries. The use of lipid-lowering drugs was relatively high (60.9%). However, the most frequently used doses of lipid-lowering agents were much lower than the doses of proven effect used in clinical trials.


CONCLUSIONS
Although the treatment of hyperlipidaemia in CHD patients seems to be improving as compared to the first survey, a significant number of patients do not reach treatment goals. If the full potential of lipid-lowering therapy was utilised with all eligible patients treated and doses titrated correctly, more patients would benefit in terms of reduced morbidity and mortality of CHD.
Kotseva
K
K
Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, Charing Cross Hospital 5th Floor, Laboratory Block, Fulham Palace Road, London W6 8RF, United Kingdom. k.kotseva@imperial.ac.uk
Stagmo
M
M
De Bacquer
D
D
De Backer
G
G
Wood
D
D
D002784:Cholesterol / Q000097:blood*; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy*; D005060:Europe; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol