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EuroAspire III

Congenital Heart Disease in Children and Adults (GUCH)


Vienna, Austria, September 2, 2007:

The third EUROASPIRE survey is part of the Euro Heart Survey programme of the ESC .The results presented at this Congress relate to the hospital arm of this survey .The primary objective is to determine whether in patients with established coronary heart disease (CHD) the European guidelines on cardiovascular disease (CVD) prevention have been implemented.

The EUROASPIRE III survey has been carried out in 75 centres from 22 European countries. The survey design and methods are very similar to those used in the previous EUROASPIRE surveys to allow comparison over time in the centres that also participate in the other.The results observed in EUROASPIRE III are evaluated against the recommendations given by the Third joint European Task force in 2003 in the guidelines on CVD prevention in clinical practice.

The study population consists of consecutive patients aged < 80 years, hospitalised because of CHD in the participating centres at least 6 months but no longer than 3 years before the survey visit.

A total of 13935 medical records were retrieved and 8966 patients participated in the visit. Standardised methods were used to study lifestyles, the management of coronary risk factors and the use of cardioprotective drugs.

At the time of the interview 17,2% of all patients was still smoking tobacco, even 38% in patients < 50years old; only one in two of those who smoked before the index event had stopped.

The prevalence rates of overweight and obesity are alarming in all centres ; the proportions with a waist circumference indicating central obesity were respectively 46 and 74% in men and women.

Regular exercise is not taken up by a majority of patients.

Control of elevated blood pressure is still problematic with more than 60% of the patients not at goal despite the fact that antihypertensive drugs are largely used.

Control of elevated total or LDL cholesterol has improved through a better use of statins; however bringing the goal for total cholesterol to < 4.5mmol/l in the guidelines of 2003 results in 51 % of patients not reaching that goal in EUROASPIRE III.

The prevalence of self reported diabetes is 23% ; another 11% has undetected diabetes and still another 30% has impaired fasting glycaemia. The therapeutic control of diabetes is poor.

Only one in three of the patients had participated in a formal cardiac rehabilitation programme.

The use of cardioprotective drugs such as anti platelet aggregants, betablockers or ACE inhibitors is high .

The overall results of EUROASPIRE III are rather disappointing. The poor results regarding diabetes, hypertension and obesity may be a reflection of adverse lifestyle developments going on in the background populations of numerous European countries.However the results also indicate that insufficient attention goes into lifestyles both from the side of the clinicians and from the patients themselves.
A more comprehensive multidisciplinary and professional approach is needed , accessible to all coronary patients and provided in each European country by existing or adapted “prevention centres”.

References

This study was presented at the ESC Congress 2007 in Vienna.