title: Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions.
abstract: Background European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV in primary care was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2014-2015 in 71 centres from 14 European countries. The main objective was to determine whether the 2012 Joint European Societies' guidelines on cardiovascular disease (CVD) prevention in people at high CVD risk have been followed in clinical practice. Methods Patients without a history of atherosclerotic disease started on either blood pressure and/or lipid and/or glucose-lowering treatments were identified and interviewed at least six months after the start of medication. Results Medical notes of 6700 patients were reviewed, and 4579 patients (58.7% women; mean age 58.8 (standard deviation (SD) 11.3) years) interviewed (interview rate 68.3%). Overall, 16.6% were smokers, 39.9% were overweight (body mass index (BMI)≥25 and <30 kg/m2), 43.5% obese (BMI ≥30 kg/m2) and 63.9% centrally obese (waist circumference of ≥88 cm for women, ≥102 cm for men). The medical risk factor control was very poor, with less than half (42.8%) of the patients on blood pressure lowering medication reaching the target of <140/90 mm Hg (<140/80 mm Hg in people with self-reported diabetes). Among treated dyslipidaemic patients only 32.7% attained the low-density lipoprotein (LDL)-cholesterol target of <2.5 mmol/l. Among people treated for type 2 diabetes mellitus, 58.5% achieved the glycated haemoglobin (HbA1c) target of <7.0%. Conclusion The EUROASPIRE IV survey shows that large proportions of patients at high CVD risk have unhealthy lifestyle habits and uncontrolled blood pressure, lipids and diabetes. The present data make it clear that more efforts must be taken to improve cardiovascular prevention in people at high CVD risk.
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|2 International Centre for Circulatory Health, Imperial College London, UK.
authors.forename: Kornelia
authors.initials: K
authors.lastname: Kotseva
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|3 Department of Public Health, University of Ghent, Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Bacquer
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|3 Department of Public Health, University of Ghent, Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: De Backer
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|4 Department of Medicine Solna, Karolinska Institutet, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|2 International Centre for Circulatory Health, Imperial College London, UK.
authors.forename: Catriona
authors.initials: C
authors.lastname: Jennings
authors.affiliation: 4 Department of Medicine Solna, Karolinska Institutet, Sweden.
authors.forename: Viveca
authors.initials: V
authors.lastname: Gyberg
authors.affiliation: 5 Cardiology Department, Hospital Santa Marta, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Abreu
authors.affiliation: 6 Cardiology Department, Hospital Santa Cruz, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Aguiar
authors.affiliation: 7 Cardiac Rehabilitation Unit, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Almudena C
authors.initials: AC
authors.lastname: Conde
authors.affiliation: 8 Republican Institute of Cardiology and Internal Diseases, Kazakhstan.
authors.forename: Kairat
authors.initials: K
authors.lastname: Davletov
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|9 Clinical Centre University of Sarajevo, Bosnia and Herzegovina.
authors.forename: Mirza
authors.initials: M
authors.lastname: Dilic
authors.affiliation: 10 Department of Cardiology, Shupyk National Medical Academy of Postgraduate Education, Ukraine.
authors.forename: Maryna
authors.initials: M
authors.lastname: Dolzhenko
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|11 Institutul de Boli Cardiovasculare, Universitatea de Medicina si Farmacie 'Victor Babes', Romania.
authors.forename: Dan
authors.initials: D
authors.lastname: Gaita
authors.affiliation: 12 Department of Cardiology, National Heart Hospital, Bulgaria.
authors.forename: Borislav
authors.initials: B
authors.lastname: Georgiev
authors.affiliation: 12 Department of Cardiology, National Heart Hospital, Bulgaria.
authors.forename: Nina
authors.initials: N
authors.lastname: Gotcheva
authors.affiliation: 13 Clinic for Endocrinology, Diabetes and Metabolic Diseases, University of Belgrade, Serbia.
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Lalic
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|14 Clinic of Cardiovascular Diseases, Vilnius University, Lithuania.
authors.forename: Aleksandras
authors.initials: A
authors.lastname: Laucevicius
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|15 Clinic for Internal Medicine Intermedica, Serbia.
authors.forename: Dragan
authors.initials: D
authors.lastname: Lovic
authors.affiliation: 11 Institutul de Boli Cardiovasculare, Universitatea de Medicina si Farmacie 'Victor Babes', Romania.
authors.forename: Silvia
authors.initials: S
authors.lastname: Mancas
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|16 University Hospital Centre, University of Zagreb, Croatia.
authors.forename: Davor
authors.initials: D
authors.lastname: Miličić
authors.affiliation: 17 National Research Centre for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Russia.
authors.forename: Raphael
authors.initials: R
authors.lastname: Oganov
authors.affiliation: 18 Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pajak
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|17 National Research Centre for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Russia.
authors.forename: Nana
authors.initials: N
authors.lastname: Pogosova
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|16 University Hospital Centre, University of Zagreb, Croatia.
authors.forename: Željko
authors.initials: Ž
authors.lastname: Reiner
authors.affiliation: 19 Centre for Medical Research, University of Banja Luka, Bosnia and Herzegovina.
authors.forename: Dusko
authors.initials: D
authors.lastname: Vulic
authors.affiliation: 1 European Society of Cardiology, Sophia Antipolis, France.|2 International Centre for Circulatory Health, Imperial College London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Wood
authors.lastname: On Behalf Of The Euroaspire Investigators
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011322:Primary Prevention / Q000379:methods*; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods*; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
keywords: EUROASPIRE; cardiovascular risk factors; guideline implementation; primary prevention