| Abstract: | BACKGROUND: The three major European scientific societies in cardiovascularmedicine—the European Society of Cardiology (ESC), theEuropean Atherosclerosis Society and the European Society ofHypertension—published in October 1994 joint recommendationson prevention of coronary heart disease in clinical practice.Patients with established coronary heart disease, or other majoratherosclerotic disease, were deemed to be the top priorityfor prevention. A European survey (EUROASPIRE) was thereforeconducted under the auspices of the ESC to describe currentclinical practice in relation to secondary prevention of coronaryheart disease. AIMS: The aims of EUROASPIRE were (i) to determine whether the majorrisk factors for coronary heart disease are recorded in patientsmedical records; (ii) to measure the modifiable risk factorsand describe their current management following hospitalization,and (ii) to determine whether first degree blood relatives havebeen screened. MEHTODS: The survey was conducted in selected geographical areas andhospitals in nine European countries. Consecutive patients ( 70 years) were identified retrospectively with the followingdiagnoses: coronary artery bypass grafting, percutaneous transluminalcoronary angioplasty, acute myocardial infarction and acutemyocardial ischaemia without infarction. Data collection wasbased on a retrospective review of hospital medical recordsand a prospective interview and examination of the patients. RESULTS: 4863 medical records were reviewed of whom 25% were women, and3569 patients were interviewed (adjusted response rate 85%)with an average age of 61 years. Nineteen percent of patientssmoked cigarettes, 25% were overweight (BMI  30 kg. m–2),53% had raised blood pressure (systolic BP 140 and/or diastolicBP 90 mmHg), 44% had raised total plasma cholesterol (totalcholesterol 5·5 mmol . l–1) and 18% were diabetic.Reported medication at interview was: antiplatelet drugs 81%,beta-blockers, 54% (58% in post-infarction patients). ACE inhibitors30% (38% in post infarction patients) and lipid lowering drugs32%. Of the patients receiving blood pressure lowering drugs(not always prescribed for the treatment of hypertension) 50%had a systolic BP <140 mmHg and 21% <160 mmHg, and ofthose receiving lipid lowering drugs, 49% had plasma total cholesterol<5·5 mmol. l–1 and 13% <6·5 mmol.l–1. Thirty-seven percent of patients had a family historyof premature coronary heart disease in a first-degree bloodrelative, but only 21% of patients reported being advised tohave their relatives screened for coronary risk factors. CONCLUSIONS: This European survey has demonstrated a high prevalence of modifiablerisk factors in coronary heart disease patients. There is considerablepotential for cardiologists and physicians to further reducecoronary heart disease morbidity and mortality and improve patientschances of survival |
