[EUROASPIRE: survey conducted by the European Society of Cardiology on secondary prevention of coronary disease. Hungarian results]

Abstract

The European Society of Cardiology, the European Atherosclerosis Society and the European Society of Hypertension published in 1994 a joint statement and recommendation on prevention of coronary heart disease in clinical practice. The EUROASPIRE study intended to investigate the present clinical practice in this respect in 9 European countries. The present paper deals with the Hungarian leg of the collaborative study. Hospital data of 546 patients below the age of 70 were reviewed of whom 29% were women. Consecutive patients were identified retrospectively with the following discharge-diagnoses: coronary bypass grafting, PTCA, acute myocardial infarction and angina pectoris. Minimum 6, in the average 18 month after the index event, patients were interviewed and examined. The participation rate was 77%. During the index hospitalisation an incomplete documentation of the main risk factors was found: blood pressure values were missing in 12%, lipid values in 48%, smoking status in 34%, body weight in 22% and family history in 46% of the cases, with wide variation between diagnostic categories. At follow-up 23% of the patients were obese (BMI > or = 30 kg/m2), 49% had elevated blood pressure (140/90 > or = Hgmm), 46% had total cholesterol above 5.5 mmol/l, 23% smoked and 27% were diabetic. 75% of the patients were on antiplatelet, 14% on anticoagulant, 58% on beta-blocking, 22% on lipid lowering, 32% on ACE-inhibitor and 44% on calcium channel blocking medication. The screening of first degree relatives was recommended in only 18% of the patients. The results speak for a substantial neglect of secondary prevention of coronary patients in the Hungarian clinical practice. However without complex detection, evaluation and management of risk factors it is impossible to reduce the recurrence and high mortality of coronary heart disease.