17 February 2015
A large number of patients who have suffered a heart attack across Europe are not improving their lifestyle enough to make the most of their recovery.
Researchers have said that less than half of all patients across the continent are receiving the benefits of cardiac rehabilitation and preventive care they need after a heart attack.
The investigators are now calling for "a new approach to cardiovascular prevention ... which integrates cardiac rehabilitation and secondary prevention into modern preventive cardiology programmes with appropriate adaptation to medical and cultural settings in each country", based on the disappointing figures for the current system.
The team added that such an approach should include multidisciplinary teams, and involvement from the patient and their families in a bid to achieve prevention targets and improve quality of life and survival.
Euroaspire IV is an ongoing survey monitored by the European Society of Cardiology EURObservational Research Programme. The latest addition included 78 centres from across 24 European countries, with nearly 8,000 coronary patients identified and interviewed. On average, the time between index event and interview was 1.35 years, and the full results are published in the European Journal of Preventive Cardiology.
Nearly half of those who had smoked before their heart attack were still smoking at their follow-up appointment, with this figure being highest among patients who were under 50 years. This is despite there being plenty of evidence to suggest that making this lifestyle change can significantly reduce the risk. Some studies show that quitting smoking can reduce coronary mortality by at least 36 per cent.
However, the researchers highlight that less than a fifth of smoking participants were asked to attend a smoking cessation clinic, and only a small amount of people did so.
The majority of coronary patients did report increasing physical activity levels and changing diet since they left hospital. However, just 40 per cent achieved a physical activity level of moderate or vigorous intensity for at least 20 minutes multiple times a week.
Most of the patients included in the study were overweight or obese, which contributes to a high level of diabetes among the group, but few had plans to lose weight. Many obese patients were uninformed about their weight, while nearly half did not follow any dietary recommendations or increase their physical activity levels.
The study's first author and chair of the Euroaspire Steering Committee Dr Kornelia Kotseva from Imperial College London's National Heart and Lung Institute called the results "very disappointing".
She said: "A large majority of coronary patients do not achieve the guideline standards for secondary prevention with high prevalences of persistent smoking, unhealthy diets, physical inactivity and consequently most patients are overweight or obese with a high prevalence of diabetes.
"Risk factor control is inadequate despite high reported use of medications and there are large variations in secondary prevention practice between centres. Despite the existence of clear, evidence-based guidelines, their integration into routine clinical care remains disappointing, and there is still much room to raise the standards of preventive cardiology throughout Europe."
Posted by Edward Bartel
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