The prevalence of smoking and obesity has not changed over the last seven years, with more than four in five people at high risk of developing cardiovascular disease being overweight or obese, according to a comparison of high cardiovascular risk patients in both the EUROASPIRE III and EUROASPIRE IV surveys presented Sept. 1 during ESC Congress 2015 in London. Additionally, therapeutic control of blood pressure and lipids has not improved significantly and the vast majority of patients do not reach the targets defined in the guidelines.

The study analyzed data from 5,890 high-risk patients from Bulgaria, Croatia, Poland, Romania and the UK who took part in the EUROASPIRE III (conducted from 2006 to 2008 in 12 countries) or the EUROASPIRE IV (conducted from 2014 to 2015 in 14 countries) surveys. Results showed no change across the two surveys in the prevalence of overweight (82 percent and 82 percent), obesity (44 percent and 43 percent) or central obesity (59 percent and 62 percent), or in levels of physical activity. Less than one in five patients in both surveys reported having vigorous physical activity outside of work for more than 20 minutes at least three times a week. Smoking prevalence also remained unchanged and was highest in patients under the age of 50. Further, researchers pointed out that the proportion of smokers with no intention of quitting increased significantly from 23 percent to 34 percent.

For most of these areas, the use of pharmacotherapy remained low and largely unchanged with few exceptions. Therapeutic control of blood pressure in patients using hypertension medication slightly improved but not significantly (28 percent and 35 percent), with 65 percent of patients in EUROASPIRE IV still above the recommended target. Both smoking cessation and glycemic control in patients with diabetes also remained unchanged. However, the proportion of patients on lipid-lowering medication who met the LDL cholesterol target (<2.5 mmol/L) increased insignificantly from 29 percent to 37 percent; but 63 percent of patients still did not reach the target.

"We wanted to see whether there had been any change in lifestyles or risk factors between the two surveys and whether the practice of preventive cardiology in patients at high risk of developing cardiovascular disease had improved over time," said Kornelia Kotseva, MD, PhD, chair of the EUROASPIRE Steering Committee and senior clinical research fellow at Imperial College London, UK. "Lifestyle trends are not moving in the right direction."

Keywords: ESC Congress, Data Collection, Europe, Family Practice, General Practice, Primary Prevention, Risk Factors

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