Euroaspire V. European Survey of Cardiovascular Disease Prevention and Diabetes

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 randmosed 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, beta blockers, 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 updated at regular
intervals. 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 the EUROASPIRE 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 mmHg, total cholesterol < 4,0 mmol/L, LDL
cholesterol < 2,0 mmol/L, if feasible and appropriate use of cardio-protective
drug therapies.

A fifth EUROASPIRE survey is now proposed under the auspices of the European
Society of Cardiology, EuroObservational Research Programma, and led by the
European Association for Cardiovascular Prevention and Rehabilitation. 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
2016-2017.

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
centers 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 comprises a visit the out-patient clinic, filling out tree
questionnaires (<5 minutes), to exhale in a breathalyzer (CO measurement), to
have a measurement of the blood pressure, and a single blood test.