By Jane Collingwood
Guidelines on heart disease prevention are failing to make a big difference to patient lifestyles, experts warned today.
Researchers led by Professor David Wood from Imperial College London, UK, surveyed the care of 3,180 patients in 22 European countries. They believe that lifestyle programmes should be the backbone of preventive care, but they found that just a third of patients are referred to and join such programmes.
Heart disease is the biggest killer in Europe, they write in the Lancet, yet it is largely preventable. Cardiovascular risk factors are modifiable through changes in smoking, diet and exercise. However, prevention efforts are inadequate and doctors are prescribing more and more drugs.
“The proportion of patients who smoke has remained the same, and the proportion of women smokers aged less than 50 years has increased,” they report.
The rate of obesity and diabetes among patients has increased. Meanwhile, there has been a “substantial increase” in drug prescribing.
There is “a compelling need for more effective lifestyle management of patients with coronary heart disease”, they conclude.
Professor Wood said: “It is a matter of the greatest professional concern that so many coronary patients are not being managed to the standards set in European prevention guidelines and as a result are at increased risk of atherosclerotic disease and a shorter life expectancy.”
In a commentary, experts from the University of Oslo in Norway, state that blood pressure and lipid targets “that are too ambitious might take focus away from important lifestyle issues”. Instead, they believe that helping patients achieve a healthy lifestyle “should be mandatory and have high priority for doctors and health authorities”.
Kotseva, K. et al. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. The Lancet, Vol. 373, March 14, 2009, pp. 929-40.
Brekke, M. and Gjelsvik, B. Secondary cardiovascular risk prevention – we can do better. The Lancet, Vol. 373, March 14, 2009, pp. 873-75.
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