title: ASPIRE-2-PREVENT: a survey of lifestyle, risk factor management and cardioprotective medication in patients with coronary heart disease and people at high risk of developing cardiovascular disease in the UK.
abstract: OBJECTIVE
  To determine in patients with coronary heart disease (CHD) and people at high risk of developing cardiovascular disease (CVD) whether the Joint British Societies' guidelines on CVD prevention (JBS2) are followed in everyday clinical practice.
  
  
  METHODS
  A cross-sectional survey was undertaken of medical records and patient interviews and examinations at least 6 months after the recruiting event or diagnosis using standardised instruments and a central laboratory for measurement of lipids and glucose.
  
  
  METHODS
  The ASPIRE-2-PREVENT survey was undertaken in 19 randomly selected hospitals and 19 randomly selected general practices in 12 geographical regions in England, Northern Ireland, Wales and Scotland.
  
  
  METHODS
  In hospitals, 1474 consecutive patients with CHD were identified and 676 (25.6% women) were interviewed. In general practice, 943 people at high CVD risk were identified and 446 (46.5% women) were interviewed.
  
  
  RESULTS
  The prevalence of risk factors in patients with CHD and high-risk individuals was, respectively: smoking 14.1%, 13.3%; obesity 38%, 50.2%; not reaching physical activity target 83.3%, 85.4%; blood pressure ≥130/80 mm Hg (patients with CHD and self-reported diabetes) or ≥140/85 mm Hg (high-risk individuals) 46.9%, 51.3%; total cholesterol ≥4 mmol/l 52.6%, 78.7%; and diabetes 17.8%, 43.8%.
  
  
  CONCLUSIONS
  The potential among patients with CHD and individuals at high risk of developing CVD in the UK to achieve the JBS2 lifestyle and risk factor targets is considerable. CVD prevention needs a comprehensive multidisciplinary approach, addressing all aspects of lifestyle and risk factor management. The challenge is to engage and motivate cardiologists, physicians and other health professionals to routinely practice high quality preventive cardiology in a healthcare system which must invest in prevention.
authors.affiliation: Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, St Mary's Campus, International Centre for Circulatory Health, Lower 3rd Floor, 59-61 North Wharf Road, London W2 1LA, UK. k.kotseva@imperial.ac.uk
authors.forename: Kornelia
authors.initials: K
authors.lastname: Kotseva
authors.forename: Catriona S
authors.initials: CS
authors.lastname: Jennings
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Turner
authors.forename: Alison
authors.initials: A
authors.lastname: Mead
authors.forename: Susan
authors.initials: S
authors.lastname: Connolly
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jones
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Bowker
authors.forename: David A
authors.initials: DA
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015992:Body Mass Index; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D003327:Coronary Disease / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy; D006973:Hypertension / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000150:complications; D015995:Prevalence; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D002316:Cardiotonic Agents; D007004:Hypoglycemic Agents