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Original Research

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

Authors:

Kornelia Kotseva ,

International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, GB
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Dirk De Bacquer,

Department of Public Health, University Hospital Ghent, Ghent, BE
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Catriona Jennings,

International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, GB
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Viveca Gyberg,

Cardiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, SE
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Guy De Backer,

Department of Public Health, University Hospital Ghent, Ghent, BE
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Lars Rydénz,

Cardiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, SE
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Philippe Amouyel,

Université Lille Nord de France, Lille, FR
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Jan Bruthans,

First Medical Faculty Charles University and Thomayer Hospital, Centre for Cardiovascular Prevention, Prague, CZ
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Renata Cifkova,

First Medical Faculty Charles University and Thomayer Hospital, Centre for Cardiovascular Prevention, Prague, CZ
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Jaap W. Deckers,

Department of Cardiology, Thoraxcenter, Rotterdam, NL
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Johan De Sutter,

AZ Maria Middelares, Ghent, BE
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Zlatko Fraz,

University Medical Centre, Ljubljana, SI
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Ian Graham,

The Adelaide and Meath Hospital, Tallaght, IE
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Irena Keber,

University Medical Centre, Ljubljana, SI
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Seppo Lehto,

Kuopio University Hospital, Kuopio, FI
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David Moore,

The Adelaide and Meath Hospital, Tallaght, IE
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Andrzej Pajak,

Zakład Epidemiologii i Badań Popupulacyjnych CMUJ, Cracow, PL
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David Wood,

International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, GB
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on behalf of the EUROASPIRE Investigators

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 evidencebased 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.

Highlights

  • Three EUROASPIRE cross-sectional surveys undertaken over 14 years
  • Time-trend analysis of lifestyle and medical risk factor control in coronary patients in Europe
  • Adverse lifestyle factors trends with increases in obesity and diabetes and stagnating rates of smoking
  • Blood pressure and lipid management improved but still not optimally controlled
  • No increase in the proportions of patients on evidence-based medications between the 2 most recent surveys
How to Cite: Kotseva K, De Bacquer D, Jennings C, Gyberg V, De Backer G, Rydénz 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. DOI: http://doi.org/10.1016/j.gheart.2015.11.003
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Published on 01 Dec 2017.
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