title: Lifestyle and risk factor management in people at high cardiovascular risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom who participated in both the EUROASPIRE III and IV primary care surveys.
abstract: The objective of this study was to determine time trends in the implementation of European guidelines on the management of cardiovascular disease prevention in people at high cardiovascular risk.
  
  
  
  Cardiovascular disease prevention as reflected in the primary care arms of the EUROASPIRE III and IV surveys were compared in centres from Bulgaria, Croatia, Poland, Romania and the United Kingdom that participated in both surveys. All patients were free of cardiovascular disease but considered at high cardiovascular disease risk since they had been started on blood pressure and/or lipid and/or glucose lowering treatments. They were interviewed and examined by means of standardized methods ≥6 months after the start of therapy.
  
  
  
  EUROASPIRE III comprised 2604 and EUROASPIRE IV 3286 subjects whereof 76% and 56% were interviewed. There were no major differences between the two surveys in age, gender, centres and reasons for inclusion. The prevalence of smoking was similar between EUROASPIRE III and IV. The proportion of smokers who did not intend to quit was significantly greater in EUROASPIRE IV compared with III. The prevalence of overweight or obesity was high and identical in both surveys. No significant differences were observed in physical activity. In participants not on blood pressure lowering treatment an elevated blood pressure was observed in 47% in both EUROASPIRE III and IV. In participants not on lipid lowering drugs the low-density lipoprotein cholesterol was ≥2.5 mmol/l in 87% and 88% in EUROASPIRE III and IV respectively. In participants free from known diabetes fasting plasma glucose was ≥7 mmol/l in 12% and 18% in EUROASPIRE III and IV. In subjects with known arterial hypertension blood pressure was at or below guideline recommended targets in 28% in EUROASPIRE III and 35% in IV. In participants on lipid lowering drugs the low-density lipoprotein cholesterol was < 2.5 mmol/l in 28% and 37% in EUROASPIRE III and IV. Glycated haemoglobin was < 7.0% in participants with known diabetes in 62% and 60% in EUROASPIRE III and IV.
  
  
  
  The results from EUROASPIRE III and IV clearly demonstrate that the control of modifiable risk factors in people at high cardiovascular disease risk remains poor.
authors.affiliation: Department of Public Health, Ghent University, Belgium European Society of Cardiology, Sophia Antipolis Cedex, France guy.debacker@ugent.be.
authors.forename: Guy
authors.initials: G
authors.lastname: De Backer
authors.affiliation: Department of Public Health, Ghent University, Belgium European Society of Cardiology, Sophia Antipolis Cedex, France.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Bacquer
authors.affiliation: European Society of Cardiology, Sophia Antipolis Cedex, France Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.affiliation: European Society of Cardiology, Sophia Antipolis Cedex, France International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, UK.
authors.forename: Kornelia
authors.initials: K
authors.lastname: Kotseva
authors.affiliation: European Society of Cardiology, Sophia Antipolis Cedex, France Universitatea de Medicina si Farmacie 'Victor Babes', Institutul de Boli Cardiovasculare, Timisoara, Romania.
authors.forename: Dan
authors.initials: D
authors.lastname: Gaita
authors.affiliation: Department of Cardiology, National Heart Hospital, Sofia, Bulgaria.
authors.forename: Borislav
authors.initials: B
authors.lastname: Georgiev
authors.affiliation: Department of Cardiology, National Heart Hospital, Sofia, Bulgaria.
authors.forename: Nina
authors.initials: N
authors.lastname: Gotcheva
authors.affiliation: European Society of Cardiology, Sophia Antipolis Cedex, France Universitatea de Medicina si Farmacie 'Victor Babes', Institutul de Boli Cardiovasculare, Timisoara, Romania.
authors.forename: Silvia
authors.initials: S
authors.lastname: Mancas
authors.affiliation: European Society of Cardiology, Sophia Antipolis Cedex, France University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Croatia.
authors.forename: Davor
authors.initials: D
authors.lastname: Miličić
authors.affiliation: Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Kracow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pająk
authors.affiliation: European Society of Cardiology, Sophia Antipolis Cedex, France University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Croatia.
authors.forename: Željko
authors.initials: Ž
authors.lastname: Reiner
authors.affiliation: European Society of Cardiology, Sophia Antipolis Cedex, France International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002031:Bulgaria / Q000453:epidemiology; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D017523:Croatia / Q000453:epidemiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002317:Cardiovascular Agents; D008055:Lipids
keywords: Prevention; cardiovascular disease; high-risk; primary care