He said this “very disappointing” finding is largely due to dramatic increases in body weight and he called for all patients to have access to professionally-led, structured prevention programmes.
Wood presented new results from the third EUROASPIRE survey, an ESC initiative. A total of 8547 coronary patients in eight countries – Czech Republic, Finland, France, Germany, Hungary, Italy, the Netherlands, Slovenia – were interviewed and examined first in the early 1990s, then in 2000 and most recently in 2006/7.
The results make depressing reading. The prevalence of smoking has not changed over the three surveys and has in fact increased among younger patients – those under 50 years – and women. Rates of obesity rose from 25% to 38% between the first and third surveys; rates of central obesity increased from 42% to 54% over the same period.
The prevalence of diabetes increased from 17% to 28%; and, despite large increases in prescriptions for all classes of antihypertensive medications, the number of patients who reached blood pressure targets (< 140/90 mmHg normally, or <130/80 mmHg in diabetes) actually fell from 41% in the first survey, to 39% in the third. “The explanation is probably the rising prevalence of overweight and obesity in these patients,” said Wood.
However, the management of blood lipids improved dramatically, driven, Wood said, by the widespread use of statins. But this was a rare positive trend.
Wood called for patients to be given professional support to make lifestyle changes. “Writing a prescription for a handful of drugs at the point when the patient is discharged from hospital is absolutely not sufficient,” he said. “These data illustrate the pressing need for preventive cardiology programmes. We invest a large amount of effort in rescuing patients with acutely ischaemic myocardia and we should make the same effort in addressing the underlying causes of the disease.
“These patients require professional intervention by a multidisciplinary team to help them change their lifestyle. They need regular monitoring and management and an understanding of why they have been given treatments, their effects and the importance of complying over the long term.”
The most recent survey found that less than one third of patients with coronary disease had access to any form of structured preventive and rehabilitative programme of care.
Read the EUROASPIRE Hot Line Session report