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Lifestyle and risk factor management in people at high cardiovascular risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom who participated in both the EUROASPIRE III and IV primary care surveys

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Abstract
Objective: The objective of this study was to determine time trends in the implementation of European guidelines on the management of cardiovascular disease prevention in people at high cardiovascular risk. Methods: Cardiovascular disease prevention as reflected in the primary care arms of the EUROASPIRE III and IV surveys were compared in centres from Bulgaria, Croatia, Poland, Romania and the United Kingdom that participated in both surveys. All patients were free of cardiovascular disease but considered at high cardiovascular disease risk since they had been started on blood pressure and/or lipid and/or glucose lowering treatments. They were interviewed and examined by means of standardized methods 6 months after the start of therapy. Results: EUROASPIRE III comprised 2604 and EUROASPIRE IV 3286 subjects whereof 76% and 56% were interviewed. There were no major differences between the two surveys in age, gender, centres and reasons for inclusion. The prevalence of smoking was similar between EUROASPIRE III and IV. The proportion of smokers who did not intend to quit was significantly greater in EUROASPIRE IV compared with III. The prevalence of overweight or obesity was high and identical in both surveys. No significant differences were observed in physical activity. In participants not on blood pressure lowering treatment an elevated blood pressure was observed in 47% in both EUROASPIRE III and IV. In participants not on lipid lowering drugs the low-density lipoprotein cholesterol was 2.5mmol/l in 87% and 88% in EUROASPIRE III and IV respectively. In participants free from known diabetes fasting plasma glucose was 7mmol/l in 12% and 18% in EUROASPIRE III and IV. In subjects with known arterial hypertension blood pressure was at or below guideline recommended targets in 28% in EUROASPIRE III and 35% in IV. In participants on lipid lowering drugs the low-density lipoprotein cholesterol was<2.5mmol/l in 28% and 37% in EUROASPIRE III and IV. Glycated haemoglobin was<7.0% in participants with known diabetes in 62% and 60% in EUROASPIRE III and IV. Conclusions: The results from EUROASPIRE III and IV clearly demonstrate that the control of modifiable risk factors in people at high cardiovascular disease risk remains poor.
Keywords
Prevention, cardiovascular disease, primary care, high-risk, BLOOD-PRESSURE, PRIMARY PREVENTION, RANDOMIZED-TRIALS, CORONARY-PATIENTS, DRUG THERAPIES, POPULATION, DISEASE, METAANALYSIS, HEALTH, COUNTRIES

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MLA
De Backer, Gui, et al. “Lifestyle and Risk Factor Management in People at High Cardiovascular Risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom Who Participated in Both the EUROASPIRE III and IV Primary Care Surveys.” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, vol. 23, no. 15, 2016, pp. 1618–27, doi:10.1177/2047487316645474.
APA
De Backer, G., De Bacquer, D., Rydén, L., Kotseva, K., Gaita, D., Georgiev, B., … Wood, D. (2016). Lifestyle and risk factor management in people at high cardiovascular risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom who participated in both the EUROASPIRE III and IV primary care surveys. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 23(15), 1618–1627. https://doi.org/10.1177/2047487316645474
Chicago author-date
De Backer, Gui, Dirk De Bacquer, Lars Rydén, Kornelia Kotseva, Dan Gaita, Borislav Georgiev, Nina Gotcheva, et al. 2016. “Lifestyle and Risk Factor Management in People at High Cardiovascular Risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom Who Participated in Both the EUROASPIRE III and IV Primary Care Surveys.” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY 23 (15): 1618–27. https://doi.org/10.1177/2047487316645474.
Chicago author-date (all authors)
De Backer, Gui, Dirk De Bacquer, Lars Rydén, Kornelia Kotseva, Dan Gaita, Borislav Georgiev, Nina Gotcheva, Silvia Mancas, Davor Miličić, Andrzej Pająk, Željko Reiner, and David Wood. 2016. “Lifestyle and Risk Factor Management in People at High Cardiovascular Risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom Who Participated in Both the EUROASPIRE III and IV Primary Care Surveys.” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY 23 (15): 1618–1627. doi:10.1177/2047487316645474.
Vancouver
1.
De Backer G, De Bacquer D, Rydén L, Kotseva K, Gaita D, Georgiev B, et al. Lifestyle and risk factor management in people at high cardiovascular risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom who participated in both the EUROASPIRE III and IV primary care surveys. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. 2016;23(15):1618–27.
IEEE
[1]
G. De Backer et al., “Lifestyle and risk factor management in people at high cardiovascular risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom who participated in both the EUROASPIRE III and IV primary care surveys,” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, vol. 23, no. 15, pp. 1618–1627, 2016.
@article{8151769,
  abstract     = {{Objective: The objective of this study was to determine time trends in the implementation of European guidelines on the management of cardiovascular disease prevention in people at high cardiovascular risk. 
Methods: Cardiovascular disease prevention as reflected in the primary care arms of the EUROASPIRE III and IV surveys were compared in centres from Bulgaria, Croatia, Poland, Romania and the United Kingdom that participated in both surveys. All patients were free of cardiovascular disease but considered at high cardiovascular disease risk since they had been started on blood pressure and/or lipid and/or glucose lowering treatments. They were interviewed and examined by means of standardized methods 6 months after the start of therapy. 
Results: EUROASPIRE III comprised 2604 and EUROASPIRE IV 3286 subjects whereof 76% and 56% were interviewed. There were no major differences between the two surveys in age, gender, centres and reasons for inclusion. The prevalence of smoking was similar between EUROASPIRE III and IV. The proportion of smokers who did not intend to quit was significantly greater in EUROASPIRE IV compared with III. The prevalence of overweight or obesity was high and identical in both surveys. No significant differences were observed in physical activity. In participants not on blood pressure lowering treatment an elevated blood pressure was observed in 47% in both EUROASPIRE III and IV. In participants not on lipid lowering drugs the low-density lipoprotein cholesterol was 2.5mmol/l in 87% and 88% in EUROASPIRE III and IV respectively. In participants free from known diabetes fasting plasma glucose was 7mmol/l in 12% and 18% in EUROASPIRE III and IV. In subjects with known arterial hypertension blood pressure was at or below guideline recommended targets in 28% in EUROASPIRE III and 35% in IV. In participants on lipid lowering drugs the low-density lipoprotein cholesterol was<2.5mmol/l in 28% and 37% in EUROASPIRE III and IV. Glycated haemoglobin was<7.0% in participants with known diabetes in 62% and 60% in EUROASPIRE III and IV. 
Conclusions: The results from EUROASPIRE III and IV clearly demonstrate that the control of modifiable risk factors in people at high cardiovascular disease risk remains poor.}},
  author       = {{De Backer, Gui and De Bacquer, Dirk and Rydén, Lars and Kotseva, Kornelia and Gaita, Dan and Georgiev, Borislav and Gotcheva, Nina and Mancas, Silvia and Miličić, Davor and Pająk, Andrzej and Reiner, Željko and Wood, David}},
  issn         = {{2047-4873}},
  journal      = {{EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY}},
  keywords     = {{Prevention,cardiovascular disease,primary care,high-risk,BLOOD-PRESSURE,PRIMARY PREVENTION,RANDOMIZED-TRIALS,CORONARY-PATIENTS,DRUG THERAPIES,POPULATION,DISEASE,METAANALYSIS,HEALTH,COUNTRIES}},
  language     = {{eng}},
  number       = {{15}},
  pages        = {{1618--1627}},
  title        = {{Lifestyle and risk factor management in people at high cardiovascular risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom who participated in both the EUROASPIRE III and IV primary care surveys}},
  url          = {{http://doi.org/10.1177/2047487316645474}},
  volume       = {{23}},
  year         = {{2016}},
}

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