Better preventive care for heart disease

There are discrepancies between the recommendations for the management of cardiovascular risk factors and their implementation in clinical practice. In the latest issue of Deutsches Arzteblatt International, Christof Prugger and his fellow authors present the results of the EUROASPIRE I, II and III surveys in the Munster region of Germany (Dtsch Arztebl Int 2012; 109(17): 303). The three surveys, conducted in 1995/96, 1999/2000 und 2006/07 respectively, permitted the authors to trace trends in cardiovascular risk factors over a 12-year period in previously hospitalized patients with coronary heart disease. All patients were aged 70 or younger and their coronary events had occurred at least 6 months before the respective survey. Although it has long been known that giving up smoking leads to a considerable reduction in the risk of cardiovascular morbidity and mortality, the prevalence of smoking remained unchanged. In contrast, the numbers of patients with high blood pressure and high cholesterol went down. The percentage of obese patients almost doubled between 1995 and 2007. The number of patients taking medications to lower their blood pressure and/or cholesterol level increased, as did the number of diabetics. The results of the EUROASPIRE I, II and III surveys in the Münster region show that the targets laid out in the European guidelines have not been achieved in clinical practice.