Objective To determine in patients with coronary heart disease (CHD) and people at high risk of developing cardiovascular disease (CVD) whether the Joint British Societies' guidelines on CVD prevention (JBS2) are followed in everyday clinical practice.
Design A cross-sectional survey was undertaken of medical records and patient interviews and examinations at least 6 months after the recruiting event or diagnosis using standardised instruments and a central laboratory for measurement of lipids and glucose.
Settings The ASPIRE-2-PREVENT survey was undertaken in 19 randomly selected hospitals and 19 randomly selected general practices in 12 geographical regions in England, Northern Ireland, Wales and Scotland.
Patients In hospitals, 1474 consecutive patients with CHD were identified and 676 (25.6% women) were interviewed. In general practice, 943 people at high CVD risk were identified and 446 (46.5% women) were interviewed.
Results The prevalence of risk factors in patients with CHD and high-risk individuals was, respectively: smoking 14.1%, 13.3%; obesity 38%, 50.2%; not reaching physical activity target 83.3%, 85.4%; blood pressure ≥130/80 mm Hg (patients with CHD and self-reported diabetes) or ≥140/85 mm Hg (high-risk individuals) 46.9%, 51.3%; total cholesterol ≥4 mmol/l 52.6%, 78.7%; and diabetes 17.8%, 43.8%.
Conclusions The potential among patients with CHD and individuals at high risk of developing CVD in the UK to achieve the JBS2 lifestyle and risk factor targets is considerable. CVD prevention needs a comprehensive multidisciplinary approach, addressing all aspects of lifestyle and risk factor management. The challenge is to engage and motivate cardiologists, physicians and other health professionals to routinely practice high quality preventive cardiology in a healthcare system which must invest in prevention.
- coronary patients
- high cardiovascular risk individuals
- risk factor management
- cardiovascular prevention
- secondary prevention, hypertension
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Funding The ASPIRE-2-PREVENT survey was supported by Merck Sharp & Dohme (MSD) with an unrestricted educational grant to Imperial College London and is part of a wider international survey called DYSIS (Dyslipidaemia International Survey). The sponsor had no role in the ASPIRE-2-PREVENT design, data collection, data analysis, data interpretation and writing of this report. The authors had full access to all data and had final responsibility for the decision to submit the manuscript for publication.
Competing interests DW serves on a Merck Sharp & Dohme Steering Committee for DYSIS and has received unrestricted research grants from MSD to Imperial College. KK and CSJ are employed by Imperial College. All other authors declare that they have no conflict of interest with regard to the work submitted for publication.
Ethics approval Ethics approval was obtained from Essex 1 Research Ethics Committee (REC: 08/H0301/33).
Provenance and peer review Not commissioned; internally peer reviewed.