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Time trends in lifestyle, risk factor control, and use of evidence-based medications in patients with coronary heart disease in Europe : results from 3 EUROASPIRE surveys, 1999-2013

(2017) GLOBAL HEART. 12(4). p.315-322
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Abstract
Background: The EUROASPIRE (European Action on Secondary and Primary Prevention by Intervention to Reduce Events) cross-sectional surveys describe time trends in lifestyle and risk factor control among coronary patients between 1999 and 2013 in Belgium, Czech Republic, Finland, France, Ireland, the Netherlands, Poland, Slovenia, and the United Kingdom as part of the EuroObservational Research Programme under the auspices of European Society of Cardiology. Objectives: This study sought to describe time trends in lifestyle, risk factor control, and the use of evidence-based medication in coronary patients across Europe. Methods: The EUROASPIRE II (1999 to 2000), III (2006 to 2007), and IV (2012 to 13) surveys were conducted in the same geographical areas and selected hospitals in each country. Consecutive patients (<= 70 years) after coronary artery bypass graft, percutaneous coronary intervention, or an acute coronary syndrome identified from hospital records were interviewed and examined >= 6 months later with standardized methods. Results: Of 12,775 identified coronary patients, 8,456 (66.2%) were interviewed. Proportion of current smokers was similar across the 3 surveys. Prevalence of obesity increased by 7%. The prevalence of raised blood pressure (>= 140/90 mm Hg or >= 140/80 mm Hg with diabetes) dropped by 8% from EUROASPIRE III to IV, and therapeutic control of blood pressure improved with 55% of patients below target in IV. The prevalence of low-density lipoprotein cholesterol >= 2.5 mmol/l decreased by 44%. In EUROASPIRE IV, 75% were above the target low-density lipoprotein cholesterol <1.8 mmol/l. The prevalence of self-reported diabetes increased by 9%. The use of evidence-based medications increased between the EUROASPIRE II and III surveys, but did not change between the III and IV surveys. Conclusions: Lifestyle habits have deteriorated over time with increases in obesity, central obesity, and diabetes and stagnating rates of persistent smoking. Although blood pressure and lipid management improved, they are still not optimally controlled and the use of evidence-based medications appears to have stalled apart from the increased use of high-intensity statins. These results underline the importance of offering coronary patients access to modern preventive cardiology programs.
Keywords
DENSITY-LIPOPROTEIN-CHOLESTEROL, RANDOMIZED CONTROLLED-TRIAL, SECONDARY PREVENTION, CARDIOVASCULAR-DISEASE, CARDIAC REHABILITATION, MYOCARDIAL-INFARCTION, COUNTRIES, GUIDELINES, METAANALYSIS, ASSOCIATION

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Chicago
Kotseva, Kornelia, Dirk De Bacquer, Catriona Jennings, Viveca Gyberg, Gui De Backer, Lars Rydén, Philippe Amouyel, et al. 2017. “Time Trends in Lifestyle, Risk Factor Control, and Use of Evidence-based Medications in Patients with Coronary Heart Disease in Europe : Results from 3 EUROASPIRE Surveys, 1999-2013.” Global Heart 12 (4): 315–322.
APA
Kotseva, Kornelia, De Bacquer, D., Jennings, C., Gyberg, V., De Backer, G., Rydén, L., Amouyel, P., et al. (2017). Time trends in lifestyle, risk factor control, and use of evidence-based medications in patients with coronary heart disease in Europe : results from 3 EUROASPIRE surveys, 1999-2013. GLOBAL HEART, 12(4), 315–322.
Vancouver
1.
Kotseva K, De Bacquer D, Jennings C, Gyberg V, De Backer G, Rydén L, et al. Time trends in lifestyle, risk factor control, and use of evidence-based medications in patients with coronary heart disease in Europe : results from 3 EUROASPIRE surveys, 1999-2013. GLOBAL HEART. 2017;12(4):315–22.
MLA
Kotseva, Kornelia, Dirk De Bacquer, Catriona Jennings, et al. “Time Trends in Lifestyle, Risk Factor Control, and Use of Evidence-based Medications in Patients with Coronary Heart Disease in Europe : Results from 3 EUROASPIRE Surveys, 1999-2013.” GLOBAL HEART 12.4 (2017): 315–322. Print.
@article{8533883,
  abstract     = {Background: The EUROASPIRE (European Action on Secondary and Primary Prevention by Intervention to Reduce Events) cross-sectional surveys describe time trends in lifestyle and risk factor control among coronary patients between 1999 and 2013 in Belgium, Czech Republic, Finland, France, Ireland, the Netherlands, Poland, Slovenia, and the United Kingdom as part of the EuroObservational Research Programme under the auspices of European Society of Cardiology. 
Objectives: This study sought to describe time trends in lifestyle, risk factor control, and the use of evidence-based medication in coronary patients across Europe. 
Methods: The EUROASPIRE II (1999 to 2000), III (2006 to 2007), and IV (2012 to 13) surveys were conducted in the same geographical areas and selected hospitals in each country. Consecutive patients ({\textlangle}= 70 years) after coronary artery bypass graft, percutaneous coronary intervention, or an acute coronary syndrome identified from hospital records were interviewed and examined {\textrangle}= 6 months later with standardized methods. 
Results: Of 12,775 identified coronary patients, 8,456 (66.2\%) were interviewed. Proportion of current smokers was similar across the 3 surveys. Prevalence of obesity increased by 7\%. The prevalence of raised blood pressure ({\textrangle}= 140/90 mm Hg or {\textrangle}= 140/80 mm Hg with diabetes) dropped by 8\% from EUROASPIRE III to IV, and therapeutic control of blood pressure improved with 55\% of patients below target in IV. The prevalence of low-density lipoprotein cholesterol {\textrangle}= 2.5 mmol/l decreased by 44\%. In EUROASPIRE IV, 75\% were above the target low-density lipoprotein cholesterol {\textlangle}1.8 mmol/l. The prevalence of self-reported diabetes increased by 9\%. The use of evidence-based medications increased between the EUROASPIRE II and III surveys, but did not change between the III and IV surveys. 
Conclusions: Lifestyle habits have deteriorated over time with increases in obesity, central obesity, and diabetes and stagnating rates of persistent smoking. Although blood pressure and lipid management improved, they are still not optimally controlled and the use of evidence-based medications appears to have stalled apart from the increased use of high-intensity statins. These results underline the importance of offering coronary patients access to modern preventive cardiology programs.},
  author       = {Kotseva, Kornelia and De Bacquer, Dirk and Jennings, Catriona and Gyberg, Viveca and De Backer, Gui and Ryd{\'e}n, Lars and Amouyel, Philippe and Bruthans, Jan and Cifkova, Renata and Deckers, Jaap W and De Sutter, Johan and Fraz, Zlatko and Graham, Ian and Keber, Irena and Lehto, Seppo and Moore, David and Pajak, Andrzej and Wood, David},
  issn         = {2211-8160},
  journal      = {GLOBAL HEART},
  keyword      = {DENSITY-LIPOPROTEIN-CHOLESTEROL,RANDOMIZED CONTROLLED-TRIAL,SECONDARY PREVENTION,CARDIOVASCULAR-DISEASE,CARDIAC REHABILITATION,MYOCARDIAL-INFARCTION,COUNTRIES,GUIDELINES,METAANALYSIS,ASSOCIATION},
  language     = {eng},
  number       = {4},
  pages        = {315--322},
  title        = {Time trends in lifestyle, risk factor control, and use of evidence-based medications in patients with coronary heart disease in Europe : results from 3 EUROASPIRE surveys, 1999-2013},
  url          = {http://dx.doi.org/10.1016/j.gheart.2015.11.003},
  volume       = {12},
  year         = {2017},
}

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