2,927 research outputs found
Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry
Get PDFAIMS: The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. DESIGN: A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. METHODS: Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. RESULTS: A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%. CONCLUSION: A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events
Primary prevention efforts are poorly developed in people at high cardiovascular risk: A report from the European Society of Cardiology EURObservational Research Programme EUROASPIRE V survey in 16 European countries
Get PDFBackground: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE)
V in primary care was carried out by the European Society of Cardiology EURObservational Research Programme in
2016–2018. The main objective was to determine whether the 2016 Joint European Societies’ guidelines on cardiovascular disease prevention in people at high cardiovascular risk have been implemented in clinical practice.
Methods: The method used was a cross-sectional survey in 78 centres from 16 European countries. Patients without a
history of atherosclerotic cardiovascular disease either started on blood pressure and/or lipid and/or glucose lowering
treatments were identified and interviewed 6 months after the start of medication.
Results: A total of 3562 medical records were reviewed and 2759 patients (57.6% women; mean age 59.0 11.6 years)
interviewed (interview rate 70.0%). The risk factor control was poor with 18.1% of patients being smokers, 43.5%
obese (body mass index 30 kg/m2
) and 63.8% centrally obese (waist circumference 88 cm for women, 102 cm for
men). Of patients on blood pressure lowering medication 47.0% reached the target of <140/90 mm Hg (<140/85 mm Hg
in people with diabetes). Among treated dyslipidaemic patients only 46.9% attained low density lipoprotein-cholesterol
target of <2.6 mmol/l. Among people treated for type 2 diabetes mellitus, 65.2% achieved the HbA1c target of <7.0%.
Conclusion: The primary care arm of the EUROASPIRE V survey revealed that large proportions of people at high
cardiovascular disease risk have unhealthy lifestyles and inadequate control of blood pressure, lipids and diabetes. Thus,
the potential to reduce the risk of future cardiovascular disease throughout Europe by improved preventive cardiology
programmes is substantial
Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry
No full textAims: The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design: A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods: Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results: A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%. Conclusion: A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events
Prevalence and types of persistent dyslipidemia in patients treated with statins
Get PDFAim To determine the prevalence and types of persistent
dyslipidemia in patients treated with different statins to
reduce cardiovascular disease (CVD) risk, as well as to determine
the proportion of high risk patients who did not
reach the lipid target values and assess cardiologists’ further
treatment advice for these patients.
Methods This cross-sectional, observational study recruited
1849 outpatients from all parts of Croatia between January
and September 2011 (44.6% women), 19 to 90 years
old (average age 63.13) treated with statins for at least 6
months. We analyzed how the potency and type of lipidlowering
treatment were correlated with CVD risk level and
achieving treatment goals according to 2007 Joint European
Guidelines on CVD prevention.
Results Most patients (81.3%) were at high risk for CVD.
The most frequently used statin was atorvastatin (42.8%),
followed by simvastatin (27.6%) and rosuvastatin (22.8%).
Only 35.5% patients achieved low density lipoproteincholesterol
treatment target. Patients treated with more
potent statins had better results. A total of 22.3% of patients
had high density lipoprotein-cholesterol below 1.0
mmol/L ( ~ 40 mg/dL) for men and below 1.2 ( ~ 45 mg/dL)
for women and 46.4% had triglycerides above 1.7 mmol/L
( ~ 150 mg/dL) but there were no significant differences between
statins in improving these parameters. Most of the
patients on more potent statins were not advised by their
cardiologists to change the type or dosage of statin, which
was more common in patients on less potent statins.
Conclusion A considerable number of patients treated
with statins did not achieve the treatment goal values. The
results were better in patients treated with more potent statins
and cardiologists advised them much less frequently
to change the type and dosage of statin. There is a need
for more intensive treatment, especially for high-risk patients.
This could be accomplished by optimizing patients’
adherence, using more potent statins, titrating current statin
therapy to higher doses, or using a combined lipid-lowering
treatment
Determinants of participation and risk factor control according to attendance in cardiac rehabilitation programmes in coronary patients in Europe: EUROASPIRE IV survey
Get PDFAim The purpose of this study was to describe the proportions of patients referred to and attending cardiac rehabilitation programmes in Europe and to compare lifestyle and risk factor targets achieved according to participation in a cardiac rehabilitation programme. Methods The EUROASPIRE IV cross-sectional survey was undertaken in 78 centres from 24 European countries. Consecutive patients aged <80 years with acute coronary syndromes and/or revascularization procedures were interviewed at least six months after their event. Results A total of 7998 patients (24% females) were interviewed. Overall, 51% were advised to participate in a cardiac rehabilitation programme and 81% of them attended at least half of the sessions; being 41% of the study population. Older patients, women, those at low socio-economic status or enrolled with percutaneous coronary intervention and unstable angina, as well as those with a previous history of coronary disease, heart failure, hypertension or dysglycaemia were less likely to be advised to follow a cardiac rehabilitation programme. People smoking prior to the recruiting event were less likely to participate. The proportions of patients achieving lifestyle targets were higher in the cardiac rehabilitation programme group as compared to the non-cardiac rehabilitation programme group: stopping smoking (57% vs 47%, p < 0.0001), recommended physical activity levels (47% vs 38%, p < 0.0001) and body mass index<30 kg/m2 (65% vs 61%, p=0.0007). However, there were no differences in the blood pressure, lipids and glucose control. Patients who attended a cardiac rehabilitation programme had significantly lower anxiety and depression scores and better medication adherence. Conclusions Only half of all coronary patients were referred and a minority attended a cardiac rehabilitation programme. Those attending were more likely to achieve lifestyle targets, had lower depression and anxiety, and better medication adherence. There is still considerable potential to further reduce cardiovascular risk by increasing uptake and fully integrating secondary prevention and cardiac rehabilitation to provide a modern preventive cardiology programme
Gender differences in risk factor management and pharmacological treatment among CHD patients: Belgian results of the EUROASPIRE IV and EUROASPIRE V surveys
No full textThe aim of this study was to provide an up-to-date overview of gender differences or similarities in risk factor control and medical management in the Belgian CHD population. All analyses are based on the ESC EORP EUROASPIRE IV and EUROASPIRE V (European Survey Of Cardiovascular Disease Prevention And Diabetes) surveys. Patients between 18 and 80 years old, hospitalised for a first or recurrent coronary event, were included in the survey. Data were available for 10,519 patients, of which 23.9% were women. Women had a worse risk factor profile compared to men. Women were more physical inactive (OR = 1.31, 95% CI = 1.19–1.44), had a higher prevalence of obesity (OR = 1.37, 95% CI = 1.25–1.50) and had a worse LDL-C control (OR = 1.52, 95% CI = 1.36–1.70). Moreover, women were less likely to use ACE-I/ARBs (OR = 0.84, 95% CI = 0.76–0.94) and statins (OR = 0.79, 95% CI = 0.70–0.90). In addition, little gender differences were found in patients’ risk factor awareness, except on cholesterol awareness. Women were more aware about their total cholesterol levels (OR = 1.37, 95% CI = 1.21–1.56). Despite little to no gender differences in the management of CHD patients, women still have a worse risk factor profile, both in Belgian and in other European high-income countries.</p
Patients with coronary artery disease and diabetes need improved management
Get PDFBackground: In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines. Methods: A total of 6187 patients (18-80years) with coronary artery disease and known glycaemic status based on a self reported history of diabetes (previously known diabetes) or the results of an oral glucose tolerance test and HbA1c (no diabetes or newly diagnosed diabetes) were investigated in EUROASPIRE IV including patients in 24 European countries 2012-2013. The patients were interviewed and investigated in order to enable a comparison between their actual risk factor control with that recommended in current European management guidelines and the outcome in previously conducted surveys. Results: A total of 2846 (46%) patients had no diabetes, 1158 (19%) newly diagnosed diabetes and 2183 (35%) previously known diabetes. The combined use of all four cardioprotective drugs in these groups was 53, 55 and 60%, respectively. A blood pressure target of 9.0% (>75mmol/mol). Of the patients with diabetes 69% reported on low physical activity. The proportion of patients participating in cardiac rehabilitation programmes was low (≈40%) and only 27% of those with diabetes had attended diabetes schools. Compared with data from previous surveys the use of cardioprotective drugs had increased and more patients were achieving the risk factor treatment targets. Conclusions: Despite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease
Gender differences in risk factor management and pharmacological treatment among CHD patients : Belgian results of the EUROASPIRE IV and EUROASPIRE V surveys
No full textAimsThe aim of this study was to provide an up-to-date overview of gender differences or similarities in risk factor control and medical management in the Belgian CHD population.MethodsAll analyses are based on the ESC EORP EUROASPIRE IV and EUROASPIRE V (European Survey Of Cardiovascular Disease Prevention And Diabetes) surveys. Patients between 18 and 80 years old, hospitalised for a first or recurrent coronary event, were included in the survey.ResultsData were available for 10,519 patients, of which 23.9% were women. Women had a worse risk factor profile compared to men. Women were more physical inactive (OR = 1.31, 95% CI = 1.19-1.44), had a higher prevalence of obesity (OR = 1.37, 95% CI = 1.25-1.50) and had a worse LDL-C control (OR = 1.52, 95% CI = 1.36-1.70). Moreover, women were less likely to use ACE-I/ARBs (OR = 0.84, 95% CI = 0.76-0.94) and statins (OR = 0.79, 95% CI = 0.70-0.90). In addition, little gender differences were found in patients' risk factor awareness, except on cholesterol awareness. Women were more aware about their total cholesterol levels (OR = 1.37, 95% CI = 1.21-1.56).ConclusionDespite little to no gender differences in the management of CHD patients, women still have a worse risk factor profile, both in Belgian and in other European high-income countries.AimsThe aim of this study was to provide an up-to-date overview of gender differences or similarities in risk factor control and medical management in the Belgian CHD population.MethodsAll analyses are based on the ESC EORP EUROASPIRE IV and EUROASPIRE V (European Survey Of Cardiovascular Disease Prevention And Diabetes) surveys. Patients between 18 and 80 years old, hospitalised for a first or recurrent coronary event, were included in the survey.ResultsData were available for 10,519 patients, of which 23.9% were women. Women had a worse risk factor profile compared to men. Women were more physical inactive (OR = 1.31, 95% CI = 1.19-1.44), had a higher prevalence of obesity (OR = 1.37, 95% CI = 1.25-1.50) and had a worse LDL-C control (OR = 1.52, 95% CI = 1.36-1.70). Moreover, women were less likely to use ACE-I/ARBs (OR = 0.84, 95% CI = 0.76-0.94) and statins (OR = 0.79, 95% CI = 0.70-0.90). In addition, little gender differences were found in patients' risk factor awareness, except on cholesterol awareness. Women were more aware about their total cholesterol levels (OR = 1.37, 95% CI = 1.21-1.56).ConclusionDespite little to no gender differences in the management of CHD patients, women still have a worse risk factor profile, both in Belgian and in other European high-income countries.A
Medical treatment in coronary patients : is there still a gender gap? Results from European Society of Cardiology EUROASPIRE V Registry
No full textPurpose This study is aimed at investigating gender differences in the medical management of patients with coronary heart disease (CHD). Methods Analyses were based on the ESC EORP EUROASPIRE V (European Survey Of Cardiovascular Disease Prevention And Diabetes) survey. Consecutive patients between 18 and 80 years, hospitalized for a coronary event, were included in the study. Information on cardiovascular medication intake at hospital discharge and at follow-up (>= 6 months to 0.01) at discharge and follow-up respectively. However, a statistically significant difference was found in the use of statins at follow-up, in disfavor of women (82.8% vs. 77.7%;P 0.01). Furthermore, women were less likely than men to have received a CABG (20.4% vs. 13.2%;P < 0.001) or PCI (82.1% vs. 74.9%; P < 0.001) at follow-up. No gender differences were observed in prescribed (P = 0.10) and attended (P = 0.63) cardiac rehabilitation programs. Conclusion The EUROASPIRE V results show only limited gender differences in the medical management of CHD patients. Current findings suggest growing awareness about risk in female CHD patients
Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries
No full textBackground and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient
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