title: EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries.
abstract: OBJECTIVE
  To determine whether the Joint European Societies guidelines on cardiovascular prevention are being followed in everyday clinical practice of secondary prevention and to describe the lifestyle, risk factor and therapeutic management of coronary patients across Europe.
  
  
  RESULTS
  EUROASPIRE IV was a cross-sectional study undertaken at 78 centres from 24 European countries. Patients <80 years with coronary disease who had coronary artery bypass graft, percutaneous coronary intervention or an acute coronary syndrome were identified from hospital records and interviewed and examined ≥ 6 months later. A total of 16,426 medical records were reviewed and 7998 patients (24.4% females) interviewed. At interview, 16.0% of patients smoked cigarettes, and 48.6% of those smoking at the time of the event were persistent smokers. Little or no physical activity was reported by 59.9%; 37.6% were obese (BMI ≥ 30 kg/m(2)) and 58.2% centrally obese (waist circumference ≥ 102 cm in men or ≥88 cm in women); 42.7% had blood pressure ≥ 140/90 mmHg (≥140/80 in people with diabetes); 80.5% had low-density lipoprotein cholesterol ≥ 1.8 mmol/l and 26.8% reported having diabetes. Cardioprotective medication was: anti-platelets 93.8%; beta-blockers 82.6%; angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75.1%; and statins 85.7%. Of the patients 50.7% were advised to participate in a cardiac rehabilitation programme and 81.3% of those advised attended at least one-half of the sessions.
  
  
  CONCLUSIONS
  A large majority of coronary patients do not achieve the guideline standards for secondary prevention with high prevalences of persistent smoking, unhealthy diets, physical inactivity and consequently most patients are overweight or obese with a high prevalence of diabetes. Risk factor control is inadequate despite high reported use of medications and there are large variations in secondary prevention practice between centres. Less than one-half of the coronary patients access cardiac prevention and rehabilitation programmes. All coronary and vascular patients require a modern preventive cardiology programme, appropriately adapted to medical and cultural settings in each country, to achieve healthier lifestyles, better risk factor control and adherence with cardioprotective medications.
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, UK k.kotseva@imperial.ac.uk.
authors: Kornelia
authors: K
authors: Kotseva
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, UK.
authors: David
authors: D
authors: Wood
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Department of Public Health, University of Ghent, Belgium.
authors: Dirk
authors: D
authors: De Bacquer
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Department of Public Health, University of Ghent, Belgium.
authors: Guy
authors: G
authors: De Backer
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
authors: Lars
authors: L
authors: Rydén
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, UK.
authors: Catriona
authors: C
authors: Jennings
authors: Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
authors: Viveca
authors: V
authors: Gyberg
authors: Institut Pasteur de Lille, Université de Lille, France.
authors: Philippe
authors: P
authors: Amouyel
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Centre for Cardiovascular Prevention, 1st Medical Faculty Charles University and Thomayer Hospital, Prague, Czech Republic.
authors: Jan
authors: J
authors: Bruthans
authors: Cardiac Rehabilitation Unit, Cardiology Department, Hospital Universitario La Paz, Madrid, Spain.
authors: Almudena
authors: A
authors: Castro Conde
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Centre for Cardiovascular Prevention, 1st Medical Faculty Charles University and Thomayer Hospital, Prague, Czech Republic.
authors: Renata
authors: R
authors: Cífková
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Thoraxcentre's Department of Cardiology, Rotterdam, The Netherlands.
authors: Jaap W
authors: JW
authors: Deckers
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Department of Internal Medicine, University of Ghent, Belgium.
authors: Johan
authors: J
authors: De Sutter
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Clinical Centre University of Sarajevo, Bosnia and Herzegovina.
authors: Mirza
authors: M
authors: Dilic
authors: Department of Cardiology, Shupyk's National Medical Academy of Postgraduate Education, Kiev, Ukraine.
authors: Maryna
authors: M
authors: Dolzhenko
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France University of Latvia, Pauls Stradins Clinical University Hospital, Riga, Latvia.
authors: Andrejs
authors: A
authors: Erglis
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France University Medical Centre, Ljubljana, Slovenia.
authors: Zlatko
authors: Z
authors: Fras
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Universitatea de Medicina si Farmacie 'Victor Babes', Institutul de Boli Cardiovasculare, Timisoara, Romania.
authors: Dan
authors: D
authors: Gaita
authors: Department of Cardiology, National Heart Hospital, Sofia, Bulgaria.
authors: Nina
authors: N
authors: Gotcheva
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Cardiology Department of Medical School University of Ioannina, Greece.
authors: John
authors: J
authors: Goudevenos
authors: Institute of Clinical Epidemiology and Biometry, University of Würzburg; Comprehensive Heart Failure Centre, University of Würzburg; Clinical Trial Centre Würzburg, University Hospital Würzburg, Germany.
authors: Peter
authors: P
authors: Heuschmann
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Clinic of Cardiovascular Diseases of Vilnius University; Heart and Vascular Medicine of Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania.
authors: Aleksandras
authors: A
authors: Laucevicius
authors: Kuopio University Hospital, Finland.
authors: Seppo
authors: S
authors: Lehto
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Clinic for Internal Medicine Intermedica, Nis, Serbia.
authors: Dragan
authors: D
authors: Lovic
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France University of Zagreb School of Medicine & University Hospital Centre Zagreb, Croatia.
authors: Davor
authors: D
authors: Miličić
authors: The Adelaide and Meath Hospital, Dublin, Ireland.
authors: David
authors: D
authors: Moore
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France University of Nicosia Medical School, Nicosia General Hospital, Cyprus.
authors: Evagoras
authors: E
authors: Nicolaides
authors: National Research Centre for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.
authors: Raphael
authors: R
authors: Oganov
authors: Jagiellonian University Medical College, Faculty of Health Sciences, Department of Epidemiology and Population Studies, Kracow, Poland.
authors: Andrzej
authors: A
authors: Pajak
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Federal Health Centre and Department of Chronic Noncommunicable Diseases Prevention, National Research Centre for Preventive Medicine, Moscow, Russia.
authors: Nana
authors: N
authors: Pogosova
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia.
authors: Zeljko
authors: Z
authors: Reiner
authors: Department of Heart Failure and Valve Disease, Skåne University Hospital, Lund, Sweden.
authors: Martin
authors: M
authors: Stagmo
authors: Comprehensive Heart Failure Centre and Department of Medicine I, University of Würzburg, Germany.
authors: Stefan
authors: S
authors: Störk
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Hacettepe University, Ankara, Turkey.
authors: Lale
authors: L
authors: Tokgözoğlu
authors: The European Society of Cardiology, Sophia Antipolis Cedex, France Centre for Medical Research, School of Medicine, University of Banja Luka, Bosnia and Herzegovina.
authors: Dusko
authors: D
authors: Vulic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002309:Cardiology / Q000639:trends*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects; D005060:Europe / Q000453:epidemiology; D015444:Exercise; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention / Q000639:trends*; D057185:Sedentary Behavior; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation; D012955:Societies, Medical; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002317:Cardiovascular Agents
keywords: EUROASPIRE; cardiovascular prevention; guidelines; rehabilitation