| Abstract: | Aims The principal aim of the second EUROASPIRE survey was todetermine in patients with established coronary heart diseasewhether the Joint European Societies' recommendations on coronaryprevention are being followed in clinical practice. Methods This survey was undertaken in 1999–2000 in 15European countries: Belgium, Czech Republic, Finland, France,Germany, Greece, Hungary, Ireland, Italy, the Netherlands, Poland,Slovenia, Sweden, Spain and the U.K., in selected geographicalareas and 47 centres. Consecutive patients, men and women  70years were identified retrospectively with the following diagnoses:coronary artery bypass graft, percutaneous transluminal coronaryangioplasty, acute myocardial infarction and myocardial ischaemia.Data collection was based on a review of medical records andinterview and risk assessment at least 6 months after hospitaladmission. Results 8181 medical records (25% women) were reviewed and 5556patients (adjusted participation rate 76%) interviewed. Recordingof risk factor history and risk factor measurement in hospitalnotes was incomplete, particularly for discharge documents.At interview (median time 1·4 years after hospital discharge),21% of patients smoked cigarettes, 31% were obese, 50% had raisedblood pressure (systolic blood pressure  140mmHg and/or diastolicblood pressure 90mmHg), 58% had elevated serum total cholesterol(total cholesterol 5mmol.l–1) and 20% reported a medicalhistory of diabetes. Glucose control in these diabetic patientswas poor with 87% having plasma glucose >6·0mmol.l–1and72% 7·0mmol.l–1. Among the patients interviewedthe use of prophylactic drug therapies on admission, at dischargeand at interview was as follows: aspirin or other antiplateletsdrugs 47%, 90% and 86%; beta-blockers 44%, 66% and 63%; ACEinhibitors 24%, 38% and 38%; and lipid-lowering drugs 26%, 43%and 61%, respectively. With the exception of antiplatelet drugs,wide variations in the use of prophylactic drug therapies existbetween countries. Conclusions This European survey of coronary patients showsa high prevalence of unhealthy lifestyles, modifiable risk factorsand inadequate use of drug therapies to achieve blood pressureand lipid goals. There is considerable potential throughoutEurope to raise the standard of preventive cardiology throughmore effective lifestyle intervention, control of other riskfactors and optimal use of prophylactic drug therapies in orderto reduce coronary morbidity and mortality. |
