title: Secondary prevention and risk factor target achievement in a global, high-risk population with established coronary heart disease: baseline results from the STABILITY study.
abstract: OBJECTIVE
  There is limited contemporary data on achievement of risk factor goals for secondary prevention of cardiovascular (CV) disease from countries in many regions of the world. This report describes the global and regional prevalence of CV risk factors and use of preventive medications at baseline in participants in the ongoing STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY (STABILITY) trial.
  
  
  RESULTS
  Detailed individual data on CV risk factors were obtained before randomization in 15,828 patients with chronic coronary heart disease (CHD) from 39 countries on five continents. Subjects had a history of myocardial infarction, prior coronary revascularization, or multi-vessel CHD without revascularization and at least one additional CV risk factor. The majority were taking a statin (97%), antiplatelet therapy (96%), beta-blocker (79%), or angiotensin converting enzyme inhibitor/angiotensin receptor blocker (77%). However, a large proportion of patients did not achieve guideline-recommended targets. For instance, in 29% low-density lipoprotein (LDL) cholesterol was >2.5 mmol/l and in 46% blood pressure was ≥140/90 mmHg or ≥130/80 mmHg in those with diabetes or renal impairment. The body mass index was >30 kg/m(2) in 36%, waist circumference ≥102 cm for men or ≥88 cm for women in 54%, and 18% were smoking. Regional differences in risk factor prevalence and target achievement were observed and were more marked for LDL cholesterol and obesity.
  
  
  CONCLUSIONS
  The prevalence of modifiable CV risk factors was generally high in the STABILITY population. Although, most patients were receiving evidence-based secondary preventive therapy many subjects from all regions did not reach recommended secondary prevention goals.
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden. ola.vedin@akademiska.se
authors.forename: Ola
authors.initials: O
authors.lastname: Vedin
authors.forename: Emil
authors.initials: E
authors.lastname: Hagström
authors.forename: Ralph
authors.initials: R
authors.lastname: Stewart
authors.forename: Rebekkah
authors.initials: R
authors.lastname: Brown
authors.forename: Susan
authors.initials: S
authors.lastname: Krug-Gourley
authors.forename: Richard
authors.initials: R
authors.lastname: Davies
authors.forename: Lars
authors.initials: L
authors.lastname: Wallentin
authors.forename: Harvey
authors.initials: H
authors.lastname: White
authors.forename: Claes
authors.initials: C
authors.lastname: Held
mesh_terms: D000368:Aged; D001547:Benzaldehydes / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D004311:Double-Blind Method; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010091:Oximes / Q000627:therapeutic use*; D064801:Phospholipase A2 Inhibitors / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D001713:Biphenyl Compounds; D004048:Diethylamines; D011744:Pyrimidinones; D013440:Sulfides
chemical_list: D001547:Benzaldehydes; D015415:Biomarkers; D001786:Blood Glucose; D002317:Cardiovascular Agents; D000960:Hypolipidemic Agents; D008055:Lipids; D010091:Oximes; D064801:Phospholipase A2 Inhibitors; C529040:darapladib; D001713:Biphenyl Compounds; D004048:Diethylamines; D011744:Pyrimidinones; D013440:Sulfides