title: Geographical variations in the prevalence and management of cardiovascular risk factors in outpatients with CAD: Data from the contemporary CLARIFY registry.
abstract: OBJECTIVE
  To determine the current prevalence and control of major cardiovascular risk factors in stable CAD outpatients worldwide.
  
  
  METHODS
  We analysed variations in cardiovascular risk factors in stable CAD outpatients from CLARIFY, a 5-year observational longitudinal cohort study, in seven geographical zones (Western/Central Europe; Canada/South Africa/Australia/UK; Eastern Europe; Central/South America; Middle East; East Asia; and India).
  
  
  RESULTS
  Patient presentation (N=32,954, mean age 64.2 years, 78% male) varied between zones, as did prevalence of risk factors (all p < 0.0001). Obesity ranged from 20% (East Asia) to 42% (Middle East), raised blood pressure from 28% (Central/South America and East Asia) to 48% (Eastern Europe), raised LDL cholesterol from 24% (Canada/South Africa/Australia/UK) to 65% (Eastern Europe), elevated heart rate (≥70 bpm) from 38% (Western/Central Europe) to 78% (India), diabetes from 17% (Eastern Europe) to 60% (Middle East), and smoking from 6% (Central/South America) to 19% (Eastern Europe). Aspirin and lipid-lowering drugs were widely used everywhere (≥84% and ≥88%, respectively). Rates of risk factor control varied geographically (all p < 0.0001). Rate of controlled blood pressure in hypertension varied from 47% (Eastern Europe) to 66% (Central/South America), glucose control in diabetes from 23% (India) to 51% (Western/Central Europe and East Asia), controlled LDL cholesterol and dyslipidaemia from 32% (Eastern Europe) to 75% (Canada/South Africa/Australia/UK), heart rate <70 bpm from 22% (India) to 62% (Western/Central Europe), and heart rate ≤60 bpm in angina patients from 2% (India) to 29% (Canada/South Africa/Australia/UK and Central/South America).
  
  
  CONCLUSIONS
  Prevalence and control of major cardiovascular risk factors in stable CAD vary markedly worldwide. Many stable CAD outpatients are being treated suboptimally.
authors.affiliation: Department of Cardiology and LTTA Centre, University Hospital of Ferrara, Cotignola, Italy Maria Cecilia Hospital, GVM Care & Research, E.S: Health Science Foundation, Cotignola, Italy fri@unife.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferrari
authors.affiliation: University of Glasgow, Glasgow, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Ford
authors.affiliation: University of Glasgow, Glasgow, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Greenlaw
authors.affiliation: Montreal Heart Institute, Université de Montreal, Montreal, Canada.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardif
authors.affiliation: Medical University of Silesia, Katowice, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Tendera
authors.affiliation: INSERM U-1148 and Université Paris Diderot Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Abergel
authors.affiliation: NHLI Imperial College, ICMS, Royal Brompton Hospital, London, UK.
authors.forename: Kim
authors.initials: K
authors.lastname: Fox
authors.affiliation: Chongqing Medical University, Chongqing, China.
authors.forename: Dayi
authors.initials: D
authors.lastname: Hu
authors.affiliation: State Research Centre for Preventive Medicine, Moscow, Russian Federation.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Shalnova
authors.affiliation: INSERM U-1148 and Université Paris Diderot Paris, France NHLI Imperial College, ICMS, Royal Brompton Hospital, London, UK AP-HP, Hôpital Bichat, Paris, France.
authors.forename: Ph Gabriel
authors.initials: PG
authors.lastname: Steg
mesh_terms: D000349:Africa / Q000453:epidemiology; D000368:Aged; D001208:Asia / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities / Q000639:trends*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010818:Practice Patterns, Physicians' / Q000639:trends*; D015995:Prevalence; D012042:Registries; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013020:South America / Q000453:epidemiology; D016896:Treatment Outcome
keywords: CLARIFY; Stable CAD; cardiovascular risk factor; geographical variation