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Not only good news in latest EUROSPIRE III findings 

Date: 31 Aug 2008
A longitudinal comparison of all three surveys conducted in the EUROASPIRE programme between 1995 and 2007 shows adverse trends in relation to overweight, obesity and diabetes in coronary patients and those at high risk of CVD.

Most striking were an increase in the proportions of those who are obese (BMI ≥30 kg/m2), rising from 25% in the first survey, 33% in the second, to 38% the third (p=0.0006), and centrally obese (waist measurement ≥88cm women, ≥102cm men) from 42% in the first survey, 53% the second, to 55% in the third (p=<0.0001).

EUROASPIRE III is the third in a series of cross-sectional surveys auditing preventive care one year after an acute cardiac event according to the European Guidelines for CVD Prevention). This third survey has included not only coronary patients and the first degree relatives of patients recruited with premature coronary disease, but also individuals at high risk of developing CVD recruited from general practice.

EUROASPIRE III also found that the prevalence of diabetes had significantly increased (17% first survey, 20% second, 28% third, p=0.004). In the 22 countries participating in EUROASPIRE III 15% of patients were found to have a fasting glucose indicative of diabetes (≥7 mmols/l) previously undetected by their physician.

Alarming is the prevalence of smoking in the coronary population which appears not to have changed across the three surveys (20% first, 21% second, 18% third, p=0.64), and even increased in women under age 50. In EUROASPIRE III, 52% of patients who were smoking in the month prior to their event were still smoking one year later at the time of their interview.

Encouragingly, however, cholesterol management has improved. Proportions with total and LDL cholesterol above 4.5 mmols per litre and 2.5 mmols per litre respectively were significantly lower. The prescription of statins has increased significantly over the course of the three surveys (18% first survey, 57% second, 87% third, p=<0.0001). However, in EUROASPIRE III one half of patients still have a total and/or LDL cholesterol above recommended levels. And from the same latest survey disappointing results were seen in the management of blood pressure: 56% of patients have a raised BP (≥140/90 mmHg or ≥130/80 mmHg in diabetics) and 37% who are on treatment are not adequately controlled.
  
Conclusion * In EUROASPIRE III nearly 14,000 hospital patients in eight countries were consecutively identified retrospectively from hospital medical records with an ACS, a PTCA procedure or CABG between September 2003 and March 2006. Nearly three quarters of eligible patients subsequently attended an interview and examination which included physical measurements of breath carbon monoxide, BP, and a blood test to measure lipids, glucose and HbA1c, and questions about lifestyle habits,  history of cardiovascular risk factors and current cardio-protective drug therapy.

Authors: Catriona Jennings
EUROSPIRE III
Research Nurse Co-ordinator
London



 
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