Evidence-based goals versus achievement in clinical practice in secondary prevention of coronary heart disease: findings in EUROASPIRE II.

Recommendations for reducing risk of recurrence in patients with established coronary heart disease (CHD) or other atherosclerotic disease were published by the Joint European Societies in 1994 and 1998. The first EUROASPIRE survey of clinical practice of secondary CHD prevention, performed in 1995 and 1996, found that 19% of CHD patients smoked cigarettes, 25% had body mass index (BMI) > or =30 kg/m(2), 53% had blood pressure > or =140/90 mmHg, and 44% had plasma total cholesterol > or =5.5 mmol/l. EUROASPIRE II, conducted in 1999 and 2000, found that 21% of patients smoked cigarettes, 31% had BMI > or =30 kg/m(2), 50% had blood pressure > or =140/90 mmHg, and 58% had serum total cholesterol > or =5.0 mmol/l. It is clear that there are still considerable opportunities in Europe to reduce risk of recurrent CHD through lifestyle changes, rigorous control of other risk factors, and more effective use of proven drug therapies.