self-reported diabetes (19%, 24%, 27%;
p = 0.004) both increased.
• Therapeutic control of blood pressure in
patients using blood pressure-lowering medication slightly improved but not significantly (28%
and 35%; p = 0.12), with 65% of patients above
the recommended target in EUROASPIRE IV.
• The proportion of patients on lipid-lowering
medication who met the low-density lipoprotein (LDL) cholesterol target increased
insignificantly—yet 63% of patients still did
not reach the target. Glycemic control in patients with diabetes remained unchanged (62%
and 60%; p = 0.75), with 40% of patients not
achieving the target of glycosylated hemoglobin
(HbA1c) < 7% in EUROASPIRE IV.
• Use of cardioprotective drugs increased between
surveys II and III, but there was no significant
change between surveys III and IV.
“We seem to have hit
a ceiling on the use
of cardioprotective
medications. Most patients
use optimal drug treatment
but do not benefit fully
because of their poor
lifestyle.” — David Wood, MD
According to professor David Wood, MD, also of
the Imperial College London: “We seem to have hit
a ceiling on the use of cardioprotective medications.
Most patients use optimal drug treatment but do
not benefit fully because of their poor lifestyle.”
He added that management of blood pressure
and lipids has improved, “but again the benefits are
mitigated by poor lifestyle and a growth in obesity
and diabetes. Our analysis highlights the pressing
need for modern preventive cardiology programs
with lifestyle change at their core and not simply
writing prescriptions for drugs.”
Dr. Keith A. A. Fox, MB, ChB, professor at the
University of Edinburgh and co-moderator of the
“Best of ESC” program, commented on the trial,
saying, “We learned from EUROASPIRE that we are
very ineffective in dealing with most of the patients
we should be treating for both primary and secondary prevention. We really need to do better to do
with what we already have in hand.”
36 CardioSource WorldNews
Dr. Sharma agreed: “People come to this [ESC] meeting to