Kornelia Kotseva1,2, Guy De Backer1,3, Dirk De Bacquer1,3, Lars Rydén1,4, Arno Hoes1,5, Diederick Grobbee1,6, Aldo Maggioni1,7, Pedro Marques-Vidal1,8, Catriona Jennings1,2, Ana Abreu9, Carlos Aguiar1,10, Jolita Badariene11,12, Jan Bruthans1,13, Almudena Castro Conde14, Renata Cifkova1,13, Jim Crowley1,15, Kairat Davletov16, Jaap Deckers1,17, Delphine De Smedt1,3, Johan De Sutter1,18,19, Mirza Dilic1,20, Marina Dolzhenko21, Vilnis Dzerve1,22, Andrejs Erglis1,23, Zlatko Fras1,24,25, Dan Gaita1,26, Nina Gotcheva27, Peter Heuschmann28,29,30, Hosam Hasan-Ali31, Piotr Jankowski32, Nebojsa Lalic33, Seppo Lehto1,34, Dragan Lovic1,35, Silvia Mancas26, Linda Mellbin1,4, Davor Milicic1,36, Erkin Mirrakhimov1,37,38, Rafael Oganov39, Nana Pogosova40, Zeljko Reiner1,41, Stefan Stöerk30,42, Lâle Tokgözoğlu1,43, Costas Tsioufis1,44, Dusko Vulic45, David Wood1,2,46. 1. 1 European Society of Cardiology, Sophia Antipolis, France. 2. 2 National Heart and Lung Institute, Imperial College London, UK. 3. 3 Department of Public Health and Primary Care, Ghent University, Belgium. 4. 4 Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. 5. 5 Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands. 6. 6 Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands. 7. 7 ANMCO Research Centre, Florence, Italy. 8. 8 Department of Medicine, Internal Medicine, Lausanne University Hospital, Switzerland. 9. 9 Hospital Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. 10. 10 Hospital Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal. 11. 11 Clinic of Cardiac and Vascular diseases, Medical Faculty, Vilnius University, Lithuania. 12. 12 Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Lithuania. 13. 13 Centre for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Czech Republic. 14. 14 Cardiac Rehabilitation Unit, Cardiology Department, Hospital Universitario La Paz, Madrid, Spain. 15. 15 Department of Cardiology, Galway University Hospital and Croí, the West of Ireland Cardiac and Stroke Foundation, Croí Heart and Stroke Centre, Galway, Ireland. 16. 16 School of Public Health, Public Health Research Centre, Kazakh National Medical University, Almaty, Kazakhstan. 17. 17 Erasmus MC, Rotterdam, The Netherlands. 18. 18 Department of Internal Medicine and Paediatrics, Ghent University, Belgium. 19. 19 AZ Maria Middelares Ghent, Belgium. 20. 20 Medical Faculty, University of Sarajevo, Bosnia and Herzegovina. 21. 21 Supyk National Medical Academy of Postgraduate Education, Kiev, Ukraine. 22. 22 Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia. 23. 23 Pauls Stradins Clinical University Hospita, University of Latvia, Riga, Latvia. 24. 24 Preventive Cardiology Unit, Department of Vascular Medicine, Division of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia. 25. 25 Medical Faculty, University of Ljubljana, Slovenia. 26. 26 Universitatea de Medicina si Farmacie Victor Babes, Institutul de Boli Cardiovasculare, Clinica de Recuperare Cardiovasculara, Timisoara, Romania. 27. 27 National Heart Hospital, Dept Cardiology, Sofia, Bulgaria. 28. 28 Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany. 29. 29 Clinical Trial Centre, University Hospital Würzburg, Germany. 30. 30 Comprehensive Heart Failure Centre, University and University Hospital Würzburg, Germany. 31. 31 Assiut University Heart Hospital, Cardiovascular Medicine Department, Egypt. 32. 32 Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland. 33. 33 Department for Metabolic Disorder, Intensive Treatment and Cell Therapy in Diabetes, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Belgrade, Serbia. 34. 34 Varkaus Hospital, Finland. 35. 35 Clinic for Internal Disease Intermedic, Cardiology Department, Hypertension Centre, Nis, Serbia. 36. 36 University of Zagreb School of Medicine & University Hospital Centre Zagreb, Croatia. 37. 37 Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan. 38. 38 National Centre of Cardiology and Internal Medicine named after academician Mirrakhimov MM, Bishkek, Kyrgyzstan. 39. 39 National Research Centre for Preventive Medicine, Directorate, Moscow, Russia. 40. 40 Federal State Budget Organization, National Medical Research Centre of Cardiology of the Ministry of Healthcare of the Russian Federation, Moscow, Russia. 41. 41 University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Croatia. 42. 42 Department of Medicine I, University Hospital Würzburg, Germany. 43. 43 Department of Cardiology, Hacettepe University, Ankara, Turkey. 44. 44 First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Greece. 45. 45 Centre for Medical Research, School of Medicine, University of Banja Luka, Republic of Srpska, Bosnia and Herzegovina. 46. 46 National University of Ireland, Galway, Ireland *Listed in Supplemental Appendix.
Abstract
AIMS: 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.
AIMS: 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.
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