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

European Heart Journal, Volume: 32, Pages: 2143 - 2152

Swansea University Author: Halcox, Julian

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DOI (Published version): 10.1093/eurheartj/ehr080

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. Methodsandresults This study was conducted with 764...

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Published in: European Heart Journal
Published: 2011
URI: https://cronfa.swan.ac.uk/Record/cronfa16040
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2016-05-04T08:21:05Z</datestamp><bib-version>v2</bib-version><id>16040</id><entry>2013-09-18</entry><title>Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study</title><alternativeTitle></alternativeTitle><author>Julian Halcox</author><firstname>Julian</firstname><surname>Halcox</surname><active>true</active><ORCID>0000-0001-6926-2947</ORCID><ethesisStudent>false</ethesisStudent><sid>3676f695eeda169d0f8c618adf27c04b</sid><email>116858a0326a6cc795f310a6bf52ee1d</email><emailaddr>6kC5ELBaQnihIKjMfkcOJX2HZhUyFASdV1DFdgIIhKs=</emailaddr><date>2013-09-18</date><deptcode>PMSC</deptcode><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. Methodsandresults 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&#x2019; 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&#x2013;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&#x2013;68.4%). Among treated type 2 diabetic patients (87.2%), 36.7% achieved the ,6.5% HbA1c target (BCR: 23.4&#x2013;48.4%). Among obese patients on non-pharmacological treatment (92.2%), 24.7% reached the body mass index target of ,30 kg/m2 (BCR: 12.7&#x2013;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.</abstract><type>Journal article</type><journal>European Heart Journal</journal><volume>32</volume><journalNumber/><paginationStart>2143</paginationStart><paginationEnd>2152</paginationEnd><publisher></publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint></issnPrint><issnElectronic></issnElectronic><keywords>Cardiovascular disease, Prevention, Hypertension, Dyslipidaemia, Diabetes, Obesity, Europe</keywords><publishedDay>0</publishedDay><publishedMonth>4</publishedMonth><publishedYear>2011</publishedYear><publishedDate>2011-04-01</publishedDate><doi>10.1093/eurheartj/ehr080</doi><url></url><notes></notes><college>Swansea University Medical School</college><department>Medicine</department><CollegeCode>CMED</CollegeCode><DepartmentCode>PMSC</DepartmentCode><institution/><researchGroup>Patient &amp; population health and informatics</researchGroup><supervisor/><sponsorsfunders/><grantnumber/><degreelevel/><degreename>None</degreename><lastEdited>2016-05-04T08:21:05Z</lastEdited><Created>2013-09-18T11:15:46Z</Created><path><level id="1">Swansea University Medical School</level><level id="2">Medicine</level></path><authors><author><firstname>Julian</firstname><surname>Halcox</surname><orcid/><order>1</order></author></authors><documents/></rfc1807>
spelling 2016-05-04T08:21:05Z v2 16040 2013-09-18 Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study Julian Halcox Julian Halcox true 0000-0001-6926-2947 false 3676f695eeda169d0f8c618adf27c04b 116858a0326a6cc795f310a6bf52ee1d 6kC5ELBaQnihIKjMfkcOJX2HZhUyFASdV1DFdgIIhKs= 2013-09-18 PMSC 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. Methodsandresults 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/m2 (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. Journal article European Heart Journal 32 2143 2152 Cardiovascular disease, Prevention, Hypertension, Dyslipidaemia, Diabetes, Obesity, Europe 0 4 2011 2011-04-01 10.1093/eurheartj/ehr080 Swansea University Medical School Medicine CMED PMSC Patient & population health and informatics None 2016-05-04T08:21:05Z 2013-09-18T11:15:46Z Swansea University Medical School Medicine Julian Halcox 1
title Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
spellingShingle Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
Halcox, Julian
title_short Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
title_full Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
title_fullStr Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
title_full_unstemmed Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
title_sort Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study
author_id_str_mv 3676f695eeda169d0f8c618adf27c04b
author_id_fullname_str_mv 3676f695eeda169d0f8c618adf27c04b_***_Halcox, Julian
author Halcox, Julian
author2 Julian Halcox
format Journal article
container_title European Heart Journal
container_volume 32
container_start_page 2143
publishDate 2011
institution Swansea University
doi_str_mv 10.1093/eurheartj/ehr080
college_str Swansea University Medical School
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hierarchy_top_id swanseauniversitymedicalschool
hierarchy_top_title Swansea University Medical School
hierarchy_parent_id swanseauniversitymedicalschool
hierarchy_parent_title Swansea University Medical School
department_str Medicine{{{_:::_}}}Swansea University Medical School{{{_:::_}}}Medicine
document_store_str 0
active_str 1
researchgroup_str Patient & population health and informatics
description 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. Methodsandresults 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/m2 (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.
published_date 2011-04-01T20:18:17Z
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