title: Excess risk attributable to traditional cardiovascular risk factors in clinical practice settings across Europe - The EURIKA Study.
abstract: BACKGROUND
  Physicians involved in primary prevention are key players in CVD risk control strategies, but the expected reduction in CVD risk that would be obtained if all patients attending primary care had their risk factors controlled according to current guidelines is unknown. The objective of this study was to estimate the excess risk attributable, firstly, to the presence of CVD risk factors and, secondly, to the lack of control of these risk factors in primary prevention care across Europe.
  
  
  METHODS
  Cross-sectional study using data from the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA), which involved primary care and outpatient clinics involved in primary prevention from 12 European countries between May 2009 and January 2010. We enrolled 7,434 patients over 50 years old with at least one cardiovascular risk factor but without CVD and calculated their 10-year risk of CVD death according to the SCORE equation, modified to take diabetes risk into account.
  
  
  RESULTS
  The average 10-year risk of CVD death in study participants (N = 7,434) was 8.2%. Hypertension, hyperlipidemia, smoking, and diabetes were responsible for 32.7 (95% confidence interval 32.0-33.4), 15.1 (14.8-15.4), 10.4 (9.9-11.0), and 16.4% (15.6-17.2) of CVD risk, respectively. The four risk factors accounted for 57.7% (57.0-58.4) of CVD risk, representing a 10-year excess risk of CVD death of 5.66% (5.47-5.85). Lack of control of hypertension, hyperlipidemia, smoking, and diabetes were responsible for 8.8 (8.3-9.3), 10.6 (10.3-10.9), 10.4 (9.9-11.0), and 3.1% (2.8-3.4) of CVD risk, respectively. Lack of control of the four risk factors accounted for 29.2% (28.5-29.8) of CVD risk, representing a 10-year excess risk of CVD death of 3.12% (2.97-3.27).
  
  
  CONCLUSIONS
  Lack of control of CVD risk factors was responsible for almost 30% of the risk of CVD death among patients participating in the EURIKA Study.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. eguallar@jhsph.edu
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.forename: José R
authors.initials: JR
authors.lastname: Banegas
authors.forename: Elena
authors.initials: E
authors.lastname: Blasco-Colmenares
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Jiménez
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
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: Mónica
authors.initials: M
authors.lastname: Tafalla
authors.forename: Joep
authors.initials: J
authors.lastname: Perk
authors.forename: Guy
authors.initials: G
authors.lastname: De Backer
authors.forename: Philippe G
authors.initials: PG
authors.lastname: Steg
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000453:epidemiology