Ljubljana, Slovenia – 20 April 2018: More than half of heart patients continue smoking after hospitalisation, according to results of the EUROASPIRE V survey presented today at EuroPrevent 2018, a European Society of Cardiology congress.1 Nearly half of obese patients have no plans for weight loss.
EUROASPIRE is a series of cross sectional surveys on cardiovascular prevention in Europe that are conducted under the ESC’s EORP initiative.2 EUROASPIRE V examined cardiovascular risk factors in 8,261 patients with established coronary heart disease from 27 countries during June 2016 to September 2018. Patients were interviewed and clinically examined six months to two years (median 1.12 years) after hospitalisation for an acute coronary event or coronary revascularisation.
Nearly one in four patients (26%) in the study were women, the average age of all study participants was 64 years, and one-third were under 60 years old.
One year after their heart attack, more than half (55%) of the patients who were smokers before hospitalisation were still smoking (almost one-fifth of all study participants).
Professor Kornelia Kotseva, chair of the EUROASPIRE Steering Committee from Imperial College London, UK, said: “Smoking is still a major problem in patients who have been hospitalised for heart disease, especially in younger patients.”
Some 38% of patients were obese (body mass index 30kg/m2 or higher), with levels ranging from 16% in Serbia to 47% in Lithuania. Of those who were obese, 45% had no plans for weight loss and 25% had never been told they had a weight problem. More than half of patients (59%) were centrally obese (waist circumference 88 cm or greater in women and 102 cm or greater in men).
The prevalence of high blood pressure (140/90 mmHg or above, and 140/80 mmHg or above in patients with diabetes) was 46% (range 31–57%), while 12% of patients had blood pressure 160/100 mmHg or above. Antihypertensive drugs were used in 78% of patients (range 49–83%), of whom 49% had controlled blood pressure (less than 140/90 mmHg, and less than 140/80 mmHg in patients with diabetes).
The prevalence of elevated low-density lipoprotein (LDL) cholesterol (1.8 mmol/L or higher) was 71%. A total of 84% of patients were taking lipid-lowering drugs (almost exclusively statins). Of these, only 32% of patients reached an LDL cholesterol target of less than 1.8 mmol/L (70 mg/dL). Most patients (93%) were on antiplatelet medication, 81% were on beta-blockers and 75% were on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.
Some 29% of patients reported that they had diabetes, but only 54% of these patients had HbA1c less than 7%, meaning their diabetes was well controlled. In addition to those with known diabetes, an oral glucose tolerance test revealed that 12% of patients had newly detected diabetes, 18% had impaired glucose tolerance, and 10% had impaired fasting glycaemia.
Less than half (46%) of patients had been advised to attend cardiac rehabilitation programmes (range 0–84%), and only 32% attended at least half of the sessions. Professor Kotseva said: “Some countries do not have any programmes on secondary prevention and rehabilitation while in others they are standard practice. Most patients follow advice to attend such programmes so the challenge is to achieve wider availability and access for all patients across Europe.”
Professor David A. Wood, Principal Investigator of EUROASPIRE from Imperial College London, said multidisciplinary, comprehensive prevention programmes were needed for all patients with coronary heart disease. He said: “We need multidisciplinary teams to address lifestyle, risk factor management and the effective use of cardioprotective drug therapies.”