Article

OBJECTIVE: To determine whether the 2003 Joint European Societies' guidelines on
cardiovascular disease prevention in people at high cardiovascular risk have been
followed in general practice. METHODS: The EUROASPIRE survey was carried out in 2006-2007 in 66 general practices in 12 European countries. Patients without a history of coronary or other
atherosclerotic disease either started on antihypertensive and/or lipid-lowering
and/or antidiabetes treatments were identified retrospectively, interviewed and
examined at least 6 months after the start of medication. RESULTS: Four thousand,
three hundred and sixty-six high-risk individuals (57.7% females) were
interviewed (participation rate 76.7%). Overall, 16.9% smoked cigarettes, 43.5%
had body mass index >/=30 kg/m, 70.8% had blood pressure >/=140/90 mmHg
(>/=130/80 in people with diabetes mellitus), 66.4% had total cholesterol >/=5.0
mmol/l (>/=4.5 mmol/l in people with diabetes) and 30.2% reported a history of
diabetes. The risk factor control was very poor, with only 26.3% of patients
using antihypertensive medication achieving the blood pressure goal, 30.6% of
patients on lipid-lowering medication achieving the total cholesterol goal and
39.9% of patients with self-reported diabetes having haemoglobin A1c </=6.1%. The
use of blood pressure-lowering medication in people with hypertension was:
beta-blockers 34.1%, angiotensin-converting enzyme inhibitors/angiotensin II
receptor blockers 60.8%, calcium channel blockers 26.3%, diuretics 36.9%. Statins
were prescribed in 47.0% of people with hypercholesterolemia. About 22.0% of all
patients were on aspirin or other antiplatelet medication. CONCLUSION: The
EUROASPIRE III survey in general practice shows that the lifestyle of people
being treated as high cardiovascular risk is a major cause of concern with
persistent smoking and high prevalence of both obesity and central obesity. Blood
pressure, lipid and glucose control are completely inadequate with most patients
not achieving the targets defined in the prevention guidelines. Primary
prevention needs a systematic, comprehensive, multidisciplinary approach, which
addresses lifestyle and risk factor management by general practitioners, nurses
and other allied health professionals, and a health care system which invests in
prevention.

Langue : ANGLAIS