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Clinical Trial
. 2011 Sep;32(17):2143-52.
doi: 10.1093/eurheartj/ehr080. Epub 2011 Apr 6.

Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study

José R Banegas  1 , Esther López-García, Jean Dallongeville, Eliseo Guallar, Julian P Halcox, Claudio Borghi, Elvira L Massó-González, Francisco J Jiménez, Joep Perk, Philippe Gabriel Steg, Guy De Backer, Fernando Rodríguez-Artalejo
Affiliations
Clinical Trial

Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study

José R Banegas et al. Eur Heart J. 2011 Sep.

Abstract

Aims: Most studies on the primary prevention of cardiovascular disease (CVD) have been limited to patients at high CVD risk. We assessed the achievement of treatment goals for CVD risk factors among patients with a substantial variation in CVD risk.

Methods and results: This study was conducted with 7641 outpatients aged ≥50 years, free of clinical CVD and with at least one major CVD risk factor, selected from 12 European countries in 2009. Risk factor definition and treatment goals were based on the 2007 European guidelines on CVD prevention. Cholesterol fractions and glycated haemoglobin (HbA1c) were measured in a central laboratory. Cardiovascular disease risk was estimated with the SCORE equation. Patients' mean age was 63 years (48% men), and 40.1% had a high CVD risk. Among treated hypertensives (94.2%), only 38.8% achieved the blood pressure target of <140/90 mmHg [between-country range (BCR): 32.1-47.5%]. Among treated dyslipidaemic patients (74.4%), 41.2% attained both the total- and LDL-cholesterol target of <5 and <3 mmol/L, respectively (BCR: 24.3-68.4%). Among treated type 2 diabetic patients (87.2%), 36.7% achieved the <6.5% HbA1c target (BCR: 23.4-48.4%). Among obese patients on non-pharmacological treatment (92.2%), 24.7% reached the body mass index target of <30 kg/m(2) (BCR: 12.7-37.1%). About one-third of controlled patients on treatment were still at high remaining CVD risk. Although most patients were advised to reduce excess weight and to follow a low-calorie diet, less than half received written recommendations.

Conclusions: In Europe, a large proportion of patients in primary prevention have CVD risk factors that remain uncontrolled, and lifestyle counselling is not well implemented; moreover, there is substantial between-country variation, which indicates additional room for improvement. Raised residual CVD risk is relatively frequent among patients despite control of their primary risk factors and should be addressed.

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Comment in

  • A half ounce of prevention ..
    Simoons ML. Simoons ML. Eur Heart J. 2011 Sep;32(17):2098-9. doi: 10.1093/eurheartj/ehr090. Epub 2011 Apr 26. Eur Heart J. 2011. PMID: 21525026 No abstract available.

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