European survey of cardiovascular disease prevention and diabetes (EuroAspire) - IV

The main objectives of cardiovascular disease (CVD) prevention are to reduce
morbidity and mortality, improve quality of life, and increase the chances of a
longer life expectancy. A wealth of scientific evidence from observational
studies and randomised controlled trials now supports interventions in relation
to lifestyle (smoking, diet and exercise), the treatment of hypertension,
hyperlipidaemia, and diabetes, and the selective use of prophylactic drug
therapies (anti-platelets, betablockers, ACE inhibitors/ARBs, lipid modifying
drugs and antithrombotics). All of these measures can reduce morbidity and
mortality in those with established coronary disease and can also help to
reduce the risk of developing this disease.
The European Society of Cardiology together with other partner Societies has
engaged in a comprehensive programme of CVD prevention in clinical
practice since 1992. Guidelines on this important topic have been developed and
updated at regular intervals over the last 15 years: 1994, 1998, 2003, 2007 and
the Vth version will be published in 2012. The aim of the Joint European
Societies Guidelines on cardiovascular disease prevention is to improve the
practice of preventive cardiology by encouraging the development of national
guidance on cardiovascular disease prevention and its communication,
implementation and evaluation through national societies in each country.
Patients with coronary or other atherosclerotic cardiovascular disease, and
those at high risk of developing CVD, have been defined as the highest clinical
priorities for prevention.
The results of EUROASPIRE I, II and III surveys demonstrated a high prevalence
of unhealthy lifestyles, modifiable risk factors and inadequate use of
drug therapies to achieve blood pressure and lipid goals in patients with
established CHD and people at high risk of developing cardiovascular disease,
with wide variations in medical practice between countries. The 2007 Joint
European Societies* Guidelines defined the lifestyle and risk factor goals for
patients with established CHD and people at high CVD risk as follows: stop
smoking, make healthy food choices and be physically active; a body mass
index (BMI) <25 kg/m2; blood pressure <130/80 mm Hg, total cholesterol <4.0
mmol/L, LDL-cholesterol <2.0 mmol/L, if feasible, and appropriate use of
cardioprotective drug therapies.
A fourth EUROASPIRE survey is now proposed under the auspices of the European
Society of Cardiology, EuroObservational Research Programme, and led by the
European Association for Cardiovascular Prevention and Rehabilitation. This
fourth survey will merge with the EuroHeart Survey on Diabetes Mellitus and
incorporate an assessment of dysgycaemia (impaired fasting glycaemia {IFG},
impaired glucose tolerance {IGT} and new diabetes) in all patients. As in the
previous EUROASPIRE surveys this survey will focus on hospital patients with
coronary heart disease, with and without diabetes mellitus, and apparently
healthy individuals in primary care at high risk of developing
cardiovascular disease including those with diabetes. The survey will be
undertaken in 2012-2013.

The objectives of EUROASPIRE IV are:
1. To determine in patients with established CHD (acute myocardial infarction
and ischaemia and patients following revascularisation by angioplasty or
coronary artery surgery) and in high multifactorial risk individuals whether
the European guidelines on cardiovascular disease prevention are being
followed.
2. To determine whether the practice of preventive cardiology in patients with
established coronary disease in EUROASPIRE IV has improved by
comparison with those hospital centres which took part in EUROASPIRE I, II and
III and whether the practice of preventive cardiology in patients in primary
care at high risk of developing CVD in EUROASPIRE IV has improved by comparison
with those centres which took part in EUROASPIRE III.
3. To compare diagnostic and therapeutic strategies in patients with
established coronary disease, and those at high multifactorial risk of
developing CVD, in relation to glucose metabolism (impaired fasting glycaemia,
impaired glucose tolerance and diabetes).
4. To compare diagnostic and therapeutic strategies in patients with
established coronary disease, and those at high multifactorial risk of
developing CVD, in relation to chronic kidney disease (CKD).
5. To follow up patients from EUROASPIRE I, II and III for total and
cause-specific mortality and morbidity to determine the relationships between
risk factors measured at interview and event-free survival.
6. To identify strategies for improving preventive care, based on the
EUROASPIRE survey results from hospital and general practice, and to make
recommendations to the European Association for Cardiovascular Prevention and
Rehabilitation.

Cross-sectional survey

The burden concerns the visit to the outpatients, filling out questionnaires,
and blood tests (OGTT incl in non-diabetic)