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European Forum on Cardiovascular Disease Prevention: from implementation to evaluation

ESC Congress 2010

Risk Factors, Epidemiology, Rehabilitation and Sports Cardiology

During the session held by the European forum held on CVD, a variety of issues were reviewed from the outline of Guidelines via their implementation, adherence to set targets, the economy of prevention and its political impact.

Prof. Ian Graham from Ireland started by discussing what we may learn from different European projects, also discussing tools and activities initiated to improve tools. He underlined that the European stage (EU) is of vital importance but there is no legal framework created. If available, it would much help implementation not only at a European, but also a national level. The framework for such legislation is available, for instance, the European Heart Health Charter and the joint European Prevention Guidelines. There are a number of important measures to be taken, not least lifestyle oriented factors, that indeed are poorly practiced. The European Association for CVD prevention and rehabilitation has created a special group working with these questions and surveys in a simple and rapid form (E-SURF) and a more comprehensive form is under way in Euroaspire 4.

In the next presentation, H. Mc Gee from Dublin reported on an evaluation of implementation of the fourth joint Task Force Guidelines for CVD prevention. A study is performed in 13 countries based on interviews with representatives of the cardiovascular profession; governmental and non-governmental organisations. Preliminary results show that different countries are working in different ways and that some have comprehensive networks created on the topic of implementation while others still have a long way to go. A detailed presentation will be ready for the European prevent summit at the European Heart House to be held on November 30, 2010.

In the next presentation, Lieven Annemanns from Gent, BE, presented a model for evaluating the cost-effectiveness of cardiovascular prevention based on EuroAspire III data and risk prediction registries across Europe. This work will fill a big gap in the knowledge on the economical impact of prevention, highly needed. The model takes into account what would happen if set blood pressure, blood lipid etc targets are reached as regards savings of QALYs. Presently, 1 QALY is valued at 30,000 Euro and by means of such information it will be possible to relate the cost of improved prevention to saved QALYs in a way which is predicted, showing that prevention truly makes sense. Once more, detailed results will be available at the European Prevention Summit, November 30 at the European Heart House.

Simon Capewell from Liverpool, UK, reviewed various signs of how EuroHeart, an EU supported shared project between the European Heart Network ande the ESC have impacted politicians view of the need for further and improved preventive measures in Europe. Several of the working packages have been labelled as European flagships in the sector of prevention and among them, he mentioned women and CHD, and the European Heart Health Charter. The NICE guidance has just been released in the UK and is well worth reading for those interested; It has been estimated that in the UK alone, one may save up to 10 billion UK pounds by reducing salt intake, increasing fruit and vegetable consumption and eliminating saturated fat. In principle, 1.5 million life years may be saved in the UK by successful implementation of healthy choices before those who are increasing the risk of CV disease. The NICE document is available on the web.

Finally, Joep Perk summarised by talking about his view on whether we have succeeded in influencing clinical care in the sector of CV prevention. His short and pessimistic view was “no – not really”. He did however expand and said that there is a long way to go and one of the problems is that we have underestimated the need for, or not been able to establish alliances between nurses, GPs, cardiologists, health workers in society and others involved. If we can do that in a better way, we will probably succeed within a reasonable future.




European Forum on Cardiovascular Disease Prevention: from implementation to evaluation

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.