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Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study

Julian Halcox Orcid Logo

European Heart Journal, Volume: 32, Pages: 2143 - 2152

Swansea University Author: Julian Halcox Orcid Logo

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DOI (Published version): 10.1093/eurheartj/ehr080

Abstract

Aims Most studies on the primary prevention of cardiovascular disease (CVD) have been limited to patients at high CVD risk. We assessed the achievement of treatment goals for CVD risk factors among patients with a substantial variation in CVD risk. Methodsandresults This study was conducted with 764...

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Published in: European Heart Journal
Published: 2011
URI: https://cronfa.swan.ac.uk/Record/cronfa16040
first_indexed 2013-09-26T11:45:54Z
last_indexed 2018-02-09T04:48:26Z
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spelling 2016-05-04T08:21:05.4057634 v2 16040 2013-09-18 Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study 3676f695eeda169d0f8c618adf27c04b 0000-0001-6926-2947 Julian Halcox Julian Halcox true false 2013-09-18 MEDS Aims Most studies on the primary prevention of cardiovascular disease (CVD) have been limited to patients at high CVD risk. We assessed the achievement of treatment goals for CVD risk factors among patients with a substantial variation in CVD risk. Methodsandresults This study was conducted with 7641 outpatients aged =50 years, free of clinical CVD and with at least one major CVD risk factor, selected from 12 European countries in 2009. Risk factor definition and treatment goals were based on the 2007 European guidelines on CVD prevention. Cholesterol fractions and glycated haemoglobin (HbA1c) were measured in a central laboratory. Cardiovascular disease risk was estimated with the SCORE equation. Patients’ mean age was 63 years (48% men), and 40.1% had a high CVD risk. Among treated hypertensives (94.2%), only 38.8% achieved the blood pressure target of ,140/90 mmHg [between-country range (BCR): 32.1–47.5%]. Among treated dyslipidaemic patients (74.4%), 41.2% attained both the total-and LDL-cholesterol target of ,5 and ,3 mmol/L, respectively (BCR: 24.3–68.4%). Among treated type 2 diabetic patients (87.2%), 36.7% achieved the ,6.5% HbA1c target (BCR: 23.4–48.4%). Among obese patients on non-pharmacological treatment (92.2%), 24.7% reached the body mass index target of ,30 kg/m2 (BCR: 12.7–37.1%). About one-third of controlled patients on treatment were still at high remaining CVD risk. Although most patients were advised to reduce excess weight and to follow a low-calorie diet, less than half received written recommendations. Conclusions In Europe, a large proportion of patients in primary prevention have CVD risk factors that remain uncontrolled, and lifestyle counselling is not well implemented; moreover, there is substantial between-country variation, which indicates additional room for improvement. Raised residual CVD risk is relatively frequent among patients despite control of their primary risk factors and should be addressed. Journal Article European Heart Journal 32 2143 2152 Cardiovascular disease, Prevention, Hypertension, Dyslipidaemia, Diabetes, Obesity, Europe 30 4 2011 2011-04-30 10.1093/eurheartj/ehr080 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University 2016-05-04T08:21:05.4057634 2013-09-18T11:15:46.7685243 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Julian Halcox 0000-0001-6926-2947 1
title Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
spellingShingle Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
Julian Halcox
title_short Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
title_full Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
title_fullStr Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
title_full_unstemmed Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
title_sort Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
author_id_str_mv 3676f695eeda169d0f8c618adf27c04b
author_id_fullname_str_mv 3676f695eeda169d0f8c618adf27c04b_***_Julian Halcox
author Julian Halcox
author2 Julian Halcox
format Journal article
container_title European Heart Journal
container_volume 32
container_start_page 2143
publishDate 2011
institution Swansea University
doi_str_mv 10.1093/eurheartj/ehr080
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 0
active_str 0
description Aims Most studies on the primary prevention of cardiovascular disease (CVD) have been limited to patients at high CVD risk. We assessed the achievement of treatment goals for CVD risk factors among patients with a substantial variation in CVD risk. Methodsandresults This study was conducted with 7641 outpatients aged =50 years, free of clinical CVD and with at least one major CVD risk factor, selected from 12 European countries in 2009. Risk factor definition and treatment goals were based on the 2007 European guidelines on CVD prevention. Cholesterol fractions and glycated haemoglobin (HbA1c) were measured in a central laboratory. Cardiovascular disease risk was estimated with the SCORE equation. Patients’ mean age was 63 years (48% men), and 40.1% had a high CVD risk. Among treated hypertensives (94.2%), only 38.8% achieved the blood pressure target of ,140/90 mmHg [between-country range (BCR): 32.1–47.5%]. Among treated dyslipidaemic patients (74.4%), 41.2% attained both the total-and LDL-cholesterol target of ,5 and ,3 mmol/L, respectively (BCR: 24.3–68.4%). Among treated type 2 diabetic patients (87.2%), 36.7% achieved the ,6.5% HbA1c target (BCR: 23.4–48.4%). Among obese patients on non-pharmacological treatment (92.2%), 24.7% reached the body mass index target of ,30 kg/m2 (BCR: 12.7–37.1%). About one-third of controlled patients on treatment were still at high remaining CVD risk. Although most patients were advised to reduce excess weight and to follow a low-calorie diet, less than half received written recommendations. Conclusions In Europe, a large proportion of patients in primary prevention have CVD risk factors that remain uncontrolled, and lifestyle counselling is not well implemented; moreover, there is substantial between-country variation, which indicates additional room for improvement. Raised residual CVD risk is relatively frequent among patients despite control of their primary risk factors and should be addressed.
published_date 2011-04-30T06:29:52Z
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score 10.969525

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