CV risk factor control in primary prevention ‘generally poor’
MedWire News: Control of cardiovascular (CV) risk factors in primary prevention remains suboptimal and varies significantly between countries, a European study has found.
Results of the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA) support intensified efforts to control risk factors among patients with all levels of CV risk, say José Banegas (Universidad Autónoma de Madrid, Spain) and fellow investigators.
The EURIKA study was a cross-sectional study conducted simultaneously in 12 European countries (Austria, Belgium, France, Germany, Greece, Norway, Russia, Spain, Sweden, Switzerland, Turkey, and the UK).
These countries were selected to represent the complete spectrum of CV risk across Europe, as well as a variety of different healthcare systems, explain the researchers in the European Heart Journal.
The study included 7641 outpatients with an average age of 63.2 years. Overall, 48.4% of participants were men, 21.3% were current smokers, 72.7% had hypertension, 57.7% had dyslipidemia, 26.8% had Type 2 diabetes, 43.6% were obese, and 19.8% were physically inactive.
None had established CV disease but, on average, 40.1% were at high risk (estimated using the SCORE equation). This figure varied significantly by country, being lowest (29.5%) in France and highest (57.3%) in Sweden.
Among patients receiving treatment for CV risk factors, achievement of treatment goals, defined according to the 2007 European guidelines, was suboptimal.
For instance, of 5559 patients with hypertension, 94.2% were receiving antihypertensive therapy, but just 38.8% had achieved the target blood pressure level of less than 140/90 mmHg.
Of 4407 patients with dyslipidemia, 74.4% were being treated with lipid-lowering drugs, but just 41.2% had achieved both total and low-density lipoprotein targets of below 5 and below 3 mmol/l, respectively.
Of 2046 patients with diabetes, 87.2% were receiving antidiabetic drugs, but just 36.7% had achieved glycated hemoglobin levels below 6.5%, while only 24.7% of obese patients receiving non-pharmacologic therapy (lifestyle advice; 92.2%) had achieved a body mass index below 30 kg/m2.
Banegas et al say their main finding was that, in 2010, "the control of CV disease risk factors in primary prevention is 'generally poor.'
"We support a more comprehensive application of the recommendation of the European guidelines for CV disease primary prevention to address the observed treatment gaps," they conclude.
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By Joanna Lyford