scholarly journals Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions

2016 ◽  
Vol 23 (18) ◽  
pp. 2007-2018 ◽  
Author(s):  
Kornelia Kotseva ◽  
Dirk De Bacquer ◽  
Guy De Backer ◽  
Lars Rydén ◽  
Catriona Jennings ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Primary Prevention ◽  
High Risk ◽  
European Society ◽  
European Regions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Factor Management ◽  
European Society Of Cardiology

scholarly journals Primary prevention efforts are poorly developed in people at high cardiovascular risk: A report from the European Society of Cardiology EURObservational Research Programme EUROASPIRE V survey in 16 European countries

2020 ◽  
pp. 204748732090869 ◽  
Author(s):  
Kornelia Kotseva ◽  
Guy De Backer ◽  
Dirk De Bacquer ◽  
Lars Rydén ◽  
Arno Hoes ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
European Society ◽  
Research Programme ◽  
European Countries ◽  
High Cardiovascular Risk ◽  
European Society Of Cardiology

Background European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V in primary care was carried out by the European Society of Cardiology EURObservational Research Programme in 2016–2018. The main objective was to determine whether the 2016 Joint European Societies’ guidelines on cardiovascular disease prevention in people at high cardiovascular risk have been implemented in clinical practice. Methods The method used was a cross-sectional survey in 78 centres from 16 European countries. Patients without a history of atherosclerotic cardiovascular disease either started on blood pressure and/or lipid and/or glucose lowering treatments were identified and interviewed ≥ 6 months after the start of medication. Results A total of 3562 medical records were reviewed and 2759 patients (57.6% women; mean age 59.0 ± 11.6 years) interviewed (interview rate 70.0%). The risk factor control was poor with 18.1% of patients being smokers, 43.5% obese (body mass index ≥30 kg/m2) and 63.8% centrally obese (waist circumference ≥88 cm for women, ≥102 cm for men). Of patients on blood pressure lowering medication 47.0% reached the target of <140/90 mm Hg (<140/85 mm Hg in people with diabetes). Among treated dyslipidaemic patients only 46.9% attained low density lipoprotein-cholesterol target of <2.6 mmol/l. Among people treated for type 2 diabetes mellitus, 65.2% achieved the HbA1c target of <7.0%. Conclusion The primary care arm of the EUROASPIRE V survey revealed that large proportions of people at high cardiovascular disease risk have unhealthy lifestyles and inadequate control of blood pressure, lipids and diabetes. Thus, the potential to reduce the risk of future cardiovascular disease throughout Europe by improved preventive cardiology programmes is substantial.

scholarly journals Cardiovascular care of patients with stroke and high risk of stroke: The need for interdisciplinary action: A consensus report from the European Society of Cardiology Cardiovascular Round Table

2019 ◽  
Vol 27 (7) ◽  
pp. 682-692 ◽  
Author(s):  
Wolfram Doehner ◽  
Mikael Mazighi ◽  
Bernd M Hofmann ◽  
Dominik Lautsch ◽  
Gerhard Hindricks ◽  
...  
Keyword(s):  
Risk Factor ◽  
European Society ◽  
Clinical Care ◽  
Round Table ◽  
Stroke Care ◽  
Care Providers ◽  
Term Care ◽  
Stroke Risk Factor ◽  
Risk Factor Management ◽  
European Society Of Cardiology

Comprehensive stroke care is an interdisciplinary challenge. Close collaboration of cardiologists and stroke physicians is critical to ensure optimum utilisation of short- and long-term care and preventive measures in patients with stroke. Risk factor management is an important strategy that requires cardiologic involvement for primary and secondary stroke prevention. Treatment of stroke generally is led by stroke physicians, yet cardiologists need to be integrated care providers in stroke units to address all cardiovascular aspects of acute stroke care, including arrhythmia management, blood pressure control, elevated levels of cardiac troponins, valvular disease/endocarditis, and the general management of cardiovascular comorbidities. Despite substantial progress in stroke research and clinical care has been achieved, relevant gaps in clinical evidence remain and cause uncertainties in best practice for treatment and prevention of stroke. The Cardiovascular Round Table of the European Society of Cardiology together with the European Society of Cardiology Council on Stroke in cooperation with the European Stroke Organisation and partners from related scientific societies, regulatory authorities and industry conveyed a two-day workshop to discuss current and emerging concepts and apparent gaps in stroke care, including risk factor management, acute diagnostics, treatments and complications, and operational/logistic issues for health care systems and integrated networks. Joint initiatives of cardiologists and stroke physicians are needed in research and clinical care to target unresolved interdisciplinary problems and to promote the best possible outcomes for patients with stroke.

scholarly journals Prescribing paradigm shift? Applying the 2019 European Society of Cardiology-led guidelines on ‘diabetes, pre-diabetes, and cardiovascular disease’ to assess eligibility for sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists as first-line monotherapy (or add-on to metformin monotherapy) in type 2 diabetes in Scotland

2020 ◽  
Author(s):  
Caparrotta Thomas M ◽  
Blackbourn Luke AK ◽  
McGurnaghan Stuart J ◽  
Chalmers John ◽  
Lindsay Robert ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
High Risk ◽  
European Society ◽  
Metformin Monotherapy ◽  
Drug Naïve ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
European Society Of Cardiology

Objective: In 2019, the European Society of Cardiology led and released new guidelines for diabetes’ cardiovascular risk management, reflecting recent evidence of cardiovascular disease (CVD) reduction with sodium-glucose co-transporter-2 inhibitors (SGLT-2i) and some glucagon-like peptide-1 receptor agonists (GLP1RA) in type 2 diabetes (T2D). A key recommendation is that all those with T2D who are (anti-hyperglycaemic) drug-naïve or on metformin monotherapy should be CVD-risk-stratified and an SGLT-2i or GLP1RA initiated in all those at high or very high risk, irrespective of glycated haemoglobin. We assessed the impact of these guidelines in Scotland were they introduced as is. <p>Research Design and Methods: Using a nationwide diabetes register in Scotland, we did a cross-sectional analysis, employing variables in our register for risk stratification at 1 January 2019. We were conservative in our definitions, assuming the absence of a risk factor where data were not available. The risk classifications were applied to those drug-naïve or metformin monotherapy people and the anticipated prescribing change calculated. </p> <p>Results: Of the 265,774 people with T2D in Scotland, 53,194 (20.0% of T2D) were drug-naïve and 56,906 (21.4%) were on metformin monotherapy. Of these, 74.5% and 72.4% respectively were estimated as at least high risk given the guideline risk definitions. </p> <p>Conclusion: Thus, 80,830 (30.4%) of <i>all</i> those with T2D (n=265,774) would start one of these drug classes according to table 7 and figure 3 of the guideline. The sizeable impact on drug budgets, enhanced clinical monitoring and the trade-off with reduced CVD-related healthcare costs will need careful consideration. </p>

scholarly journals Prescribing paradigm shift? Applying the 2019 European Society of Cardiology-led guidelines on ‘diabetes, pre-diabetes, and cardiovascular disease’ to assess eligibility for sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists as first-line monotherapy (or add-on to metformin monotherapy) in type 2 diabetes in Scotland

2020 ◽  
Author(s):  
Caparrotta Thomas M ◽  
Blackbourn Luke AK ◽  
McGurnaghan Stuart J ◽  
Chalmers John ◽  
Lindsay Robert ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
High Risk ◽  
European Society ◽  
Metformin Monotherapy ◽  
Drug Naïve ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
European Society Of Cardiology

Objective: In 2019, the European Society of Cardiology led and released new guidelines for diabetes’ cardiovascular risk management, reflecting recent evidence of cardiovascular disease (CVD) reduction with sodium-glucose co-transporter-2 inhibitors (SGLT-2i) and some glucagon-like peptide-1 receptor agonists (GLP1RA) in type 2 diabetes (T2D). A key recommendation is that all those with T2D who are (anti-hyperglycaemic) drug-naïve or on metformin monotherapy should be CVD-risk-stratified and an SGLT-2i or GLP1RA initiated in all those at high or very high risk, irrespective of glycated haemoglobin. We assessed the impact of these guidelines in Scotland were they introduced as is. <p>Research Design and Methods: Using a nationwide diabetes register in Scotland, we did a cross-sectional analysis, employing variables in our register for risk stratification at 1 January 2019. We were conservative in our definitions, assuming the absence of a risk factor where data were not available. The risk classifications were applied to those drug-naïve or metformin monotherapy people and the anticipated prescribing change calculated. </p> <p>Results: Of the 265,774 people with T2D in Scotland, 53,194 (20.0% of T2D) were drug-naïve and 56,906 (21.4%) were on metformin monotherapy. Of these, 74.5% and 72.4% respectively were estimated as at least high risk given the guideline risk definitions. </p> <p>Conclusion: Thus, 80,830 (30.4%) of <i>all</i> those with T2D (n=265,774) would start one of these drug classes according to table 7 and figure 3 of the guideline. The sizeable impact on drug budgets, enhanced clinical monitoring and the trade-off with reduced CVD-related healthcare costs will need careful consideration. </p>

scholarly journals ASPIRE-3-PREVENT: a cross-sectional survey of preventive care after a coronary event across the UK

Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001196
Author(s):  
Catriona S Jennings ◽  
Kornelia Kotseva ◽  
Paul Bassett ◽  
Agnieszka Adamska ◽  
David Wood
Keyword(s):  
Risk Factor ◽  
Artery Bypass ◽  
Coronary Event ◽  
Lifestyle Risk Factor ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Factor Management ◽  
Preventive Cardiology ◽  
Coronary Syndrome ◽  
Lifestyle Risk

ObjectiveTo quantify the implementation of the third Joint British Societies’ Consensus Recommendations for the Prevention of Cardiovascular Disease (JBS3) after coronary event.MethodsUsing a cross-sectional survey design, patients were consecutively identified in 36 specialist and district general hospitals between 6 months and 2 years, after acute coronary syndrome or revascularisation procedure and invited to a research interview. Outcomes included JBS3 lifestyle, risk factor and therapeutic management goals. Data were collected using standardised methods and instruments by trained study nurses. Blood was analysed in a central laboratory and a glucose tolerance test was performed.Results3926 eligible patients were invited to participate and 1177 (23.3% women) were interviewed (30% response). 12.5% were from black and minority ethnic groups. 45% were persistent smokers, 36% obese, 52.9% centrally obese, 52% inactive; 30% had a blood pressure >140/90 mm Hg, 54% non-high-density lipoprotein ≥2.5 mmol/L and 44.3% had new dysglycaemia. Prescribing was highest for antiplatelets (94%) and statins (85%). 81% were advised to attend cardiac rehabilitation (86% <60 years vs 79% ≥60 years; 82% men vs 77% women; 93% coronary artery bypass grafting vs 59% unstable angina), 85% attended if advised; 69% attended overall. Attenders were significantly younger (p=0.03) and women were less likely to attend (p=0.03).ConclusionsPatients with coronary heart disease (CHD) are not being adequately managed after event with preventive measures. They require a structured preventive cardiology programme addressing lifestyle, risk factor management and adherence to cardioprotective medications to achieve the standards set by the British Association for Cardiovascular Prevention and Rehabilitation and JBS3 guidelines.

General practice capacity for behavioural risk factor management: A SNAP-shot of a needs assessment in Australia

2005 ◽  
Vol 11 (2) ◽  
pp. 120 ◽  
Author(s):  
Cheryl Amoroso ◽  
Coletta Hobbs ◽  
Mark F Harris
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
General Practice ◽  
Risk Factor ◽  
Nutritional Risk ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Activity Increase ◽  
Risk Factor Management ◽  
Rural And Urban

The objective of this study is to examine current activities, barriers, and capacity needs for the assessment and management of smoking, nutrition, alcohol and physical activity behavioural risk factors in rural and urban general practices. A cross-sectional survey of 287 general practitioners (GPs) was conducted in a rural and urban Division of General Practice in NSW. A total of 146 GPs responded yielding Divisional response rates of 51% rural and 61% urban. For each of the SNAP risk factors, between 37% and 46% of GPs report using guidelines. Verbal advice is given "very often" for smoking by 68% of GPs, for nutrition and alcohol by 48%, and physical activity by 60%. Guideline use is associated with increased frequency of advising patients. Patient compliance is the most frequently reported barrier to giving advice, especially for smoking and alcohol. GPs report that they "often" or "very often" refer patients due to nutritional risk factors (48%), with lower referral rates reported for physical activity and alcohol risk factors (28% and 27% respectively). Only 10% refer patients "often" or "very often" for smoking management, and referral for smoking management and physical activity increase as a result of training in these areas. There is considerable variability in smoking, nutrition, alcohol and physical activity risk factor intervention and management in the general practice setting. A range of strategies is required to improve the systematic management of risk factors including training, use of guidelines, referral networks, and patient education.

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