title: Time Trends in Lifestyle, Risk Factor Control, and Use of Evidence-Based Medications in Patients With Coronary Heart Disease in Europe: Results From 3 EUROASPIRE Surveys, 1999-2013.
abstract: The EUROASPIRE (European Action on Secondary and Primary Prevention by Intervention to Reduce Events) cross-sectional surveys describe time trends in lifestyle and risk factor control among coronary patients between 1999 and 2013 in Belgium, Czech Republic, Finland, France, Ireland, the Netherlands, Poland, Slovenia, and the United Kingdom as part of the EuroObservational Research Programme under the auspices of European Society of Cardiology.
  
  
  
  This study sought to describe time trends in lifestyle, risk factor control, and the use of evidence-based medication in coronary patients across Europe.
  
  
  
  The EUROASPIRE II (1999 to 2000), III (2006 to 2007), and IV (2012 to 13) surveys were conducted in the same geographical areas and selected hospitals in each country. Consecutive patients (≤70 years) after coronary artery bypass graft, percutaneous coronary intervention, or an acute coronary syndrome identified from hospital records were interviewed and examined ≥6 months later with standardized methods.
  
  
  
  Of 12,775 identified coronary patients, 8,456 (66.2%) were interviewed. Proportion of current smokers was similar across the 3 surveys. Prevalence of obesity increased by 7%. The prevalence of raised blood pressure (≥140/90 mm Hg or ≥140/80 mm Hg with diabetes) dropped by 8% from EUROASPIRE III to IV, and therapeutic control of blood pressure improved with 55% of patients below target in IV. The prevalence of low-density lipoprotein cholesterol ≥2.5 mmol/l decreased by 44%. In EUROASPIRE IV, 75% were above the target low-density lipoprotein cholesterol <1.8 mmol/l. The prevalence of self-reported diabetes increased by 9%. The use of evidence-based medications increased between the EUROASPIRE II and III surveys, but did not change between the III and IV surveys.
  
  
  
  Lifestyle habits have deteriorated over time with increases in obesity, central obesity, and diabetes and stagnating rates of persistent smoking. Although blood pressure and lipid management improved, they are still not optimally controlled and the use of evidence-based medications appears to have stalled apart from the increased use of high-intensity statins. These results underline the importance of offering coronary patients access to modern preventive cardiology programs.
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom. Electronic address: k.kotseva@imperial.ac.uk.
authors.forename: Kornelia
authors.initials: K
authors.lastname: Kotseva
authors.affiliation: Department of Public Health, University Hospital Ghent, Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Bacquer
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
authors.forename: Catriona
authors.initials: C
authors.lastname: Jennings
authors.affiliation: Cardiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Viveca
authors.initials: V
authors.lastname: Gyberg
authors.affiliation: Department of Public Health, University Hospital Ghent, Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: De Backer
authors.affiliation: Cardiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.affiliation: Institut Pasteur de Lille, Inserm U744, Université Lille Nord de France, Lille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Amouyel
authors.affiliation: First Medical Faculty Charles University and Thomayer Hospital, Centre for Cardiovascular Prevention, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Bruthans
authors.affiliation: First Medical Faculty Charles University and Thomayer Hospital, Centre for Cardiovascular Prevention, Prague, Czech Republic.
authors.forename: Renata
authors.initials: R
authors.lastname: Cifkova
authors.affiliation: Department of Cardiology, Thoraxcenter, Rotterdam, the Netherlands.
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Deckers
authors.affiliation: AZ Maria Middelares, Ghent, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: De Sutter
authors.affiliation: University Medical Centre, Ljubljana, Slovenia.
authors.forename: Zlatko
authors.initials: Z
authors.lastname: Fraz
authors.affiliation: The Adelaide and Meath Hospital, Tallaght, Ireland.
authors.forename: Ian
authors.initials: I
authors.lastname: Graham
authors.affiliation: University Medical Centre, Ljubljana, Slovenia.
authors.forename: Irena
authors.initials: I
authors.lastname: Keber
authors.affiliation: Kuopio University Hospital, Kuopio, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Lehto
authors.affiliation: The Adelaide and Meath Hospital, Tallaght, Ireland.
authors.forename: David
authors.initials: D
authors.lastname: Moore
authors.affiliation: Zakład Epidemiologii i Badań Popupulacyjnych CMUJ, Cracow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pajak
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D011322:Primary Prevention / Q000379:methods*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D002317:Cardiovascular Agents