title: Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study.
abstract: OBJECTIVE
  Most studies on the primary prevention of cardiovascular disease (CVD) have been limited to patients at high CVD risk. We assessed the achievement of treatment goals for CVD risk factors among patients with a substantial variation in CVD risk.
  
  
  RESULTS
  This study was conducted with 7641 outpatients aged ≥50 years, free of clinical CVD and with at least one major CVD risk factor, selected from 12 European countries in 2009. Risk factor definition and treatment goals were based on the 2007 European guidelines on CVD prevention. Cholesterol fractions and glycated haemoglobin (HbA1c) were measured in a central laboratory. Cardiovascular disease risk was estimated with the SCORE equation. Patients' mean age was 63 years (48% men), and 40.1% had a high CVD risk. Among treated hypertensives (94.2%), only 38.8% achieved the blood pressure target of <140/90 mmHg [between-country range (BCR): 32.1-47.5%]. Among treated dyslipidaemic patients (74.4%), 41.2% attained both the total- and LDL-cholesterol target of <5 and <3 mmol/L, respectively (BCR: 24.3-68.4%). Among treated type 2 diabetic patients (87.2%), 36.7% achieved the <6.5% HbA1c target (BCR: 23.4-48.4%). Among obese patients on non-pharmacological treatment (92.2%), 24.7% reached the body mass index target of <30 kg/m(2) (BCR: 12.7-37.1%). About one-third of controlled patients on treatment were still at high remaining CVD risk. Although most patients were advised to reduce excess weight and to follow a low-calorie diet, less than half received written recommendations.
  
  
  CONCLUSIONS
  In Europe, a large proportion of patients in primary prevention have CVD risk factors that remain uncontrolled, and lifestyle counselling is not well implemented; moreover, there is substantial between-country variation, which indicates additional room for improvement. Raised residual CVD risk is relatively frequent among patients despite control of their primary risk factors and should be addressed.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Avda Arzobispo Morcillo 2, Madrid, Spain. joseramon.banegas@uam.es
authors.forename: José R
authors.initials: JR
authors.lastname: Banegas
authors.forename: Esther
authors.initials: E
authors.lastname: López-García
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.forename: Julian P
authors.initials: JP
authors.lastname: Halcox
authors.forename: Claudio
authors.initials: C
authors.lastname: Borghi
authors.forename: Elvira L
authors.initials: EL
authors.lastname: Massó-González
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Jiménez
authors.forename: Joep
authors.initials: J
authors.lastname: Perk
authors.forename: Philippe Gabriel
authors.initials: PG
authors.lastname: Steg
authors.forename: Guy
authors.initials: G
authors.lastname: De Backer
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D050171:Dyslipidemias / Q000188:drug therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control; D011322:Primary Prevention; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D008055:Lipids