Article

AIMS: To determine whether the Joint European Societies guidelines on
cardiovascular prevention are being followed in everyday clinical practice of
secondary prevention and to describe the lifestyle, risk factor and therapeutic
management of coronary patients across Europe. METHODS : EUROASPIRE IV
was a cross-sectional study undertaken at 78 centres from 24 European countries.
Patients <80 years with coronary disease who had coronary artery bypass graft,
percutaneous coronary intervention or an acute coronary syndrome were identified
from hospital records and interviewed and examined >/= 6 months later. A total of
16,426 medical records were reviewed and 7998 patients (24.4% females)
interviewed. At interview, 16.0% of patients smoked cigarettes, and 48.6% of
those smoking at the time of the event were persistent smokers. Little or no
physical activity was reported by 59.9%; 37.6% were obese (BMI >/= 30 kg/m(2))
and 58.2% centrally obese (waist circumference >/= 102 cm in men or >/=88 cm in
women); 42.7% had blood pressure >/= 140/90 mmHg (>/=140/80 in people with
diabetes); 80.5% had low-density lipoprotein cholesterol >/= 1.8 mmol/l and 26.8%
reported having diabetes. Cardioprotective medication was: anti-platelets 93.8%;
beta-blockers 82.6%; angiotensin-converting enzyme inhibitors/angiotensin
receptor blockers 75.1%; and statins 85.7%. Of the patients 50.7% were advised to
participate in a cardiac rehabilitation programme and 81.3% of those advised
attended at least one-half of the sessions. CONCLUSION: A large majority of
coronary patients do not achieve the guideline standards for secondary prevention
with high prevalences of persistent smoking, unhealthy diets, physical inactivity
and consequently most patients are overweight or obese with a high prevalence of
diabetes. Risk factor control is inadequate despite high reported use of
medications and there are large variations in secondary prevention practice
between centres. Less than one-half of the coronary patients access cardiac
prevention and rehabilitation programmes. All coronary and vascular patients
require a modern preventive cardiology programme, appropriately adapted to
medical and cultural settings in each country, to achieve healthier lifestyles,
better risk factor control and adherence with cardioprotective medications.
CI - (c) The European Society of Cardiology 2015.

Langue : ANGLAIS