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International Journal of Behavioral Medicine

Published in:

01-06-2018

Secondary Prevention in Younger vs. Older Coronary Heart Disease Patients—Insights from the German Subset of the EUROASPIRE IV Survey

Authors: Martin Wagner, Götz Gelbrich, Julia Kircher, Kornelia Kotseva, David Wood, Caroline Morbach, Rainer Leyh, Georg Ertl, Wolfgang Karmann, Stefan Störk, Peter U. Heuschmann

Published in: International Journal of Behavioral Medicine | Issue 3/2018

Abstract

Purpose

Evidence is limited on implementation of secondary prevention guidelines for coronary heart disease (CHD) in clinical practice and variations between younger and elder patients. We investigated the control of cardiovascular risk factors in German patients with CHD enrolled in the European-wide EUROASPIRE IV survey, stratified by younger (18–69 years) and older (70–79 years) age groups.

Method

Eligible subjects were identified via the hospitals’ patient information system and invited to attend a study visit 6 months to 3 years after hospitalization for CHD (myocardial infarction, ischemia, angioplasty/stent, coronary bypass grafting). Information on lifestyle and medication was collected by interview.

Results

Five hundred thirty-six patients were recruited in 2012–2013 (median age 69 years [IQR 62–74 years], 18% female, 44% ≥ 70 years of age, median time between index hospitalization and study visit 1.8 [1.1–2.5] years). Proportion of CHD patients receiving recommended drug therapy was 89% for platelet inhibitors (younger vs. older patients 93 vs. 84%, p < 0.01), 83% for statins (83 vs. 85%, p = 0.9), and 83% for beta-blockers (87 vs. 79%, p = 0.02). Uncontrolled blood pressure was observed in 45% (40 vs. 50%, p = 0.02), LDL cholesterol levels > 2.5 mmol/l in 53% (56 vs. 49%, p = 0.1), and HbA1c levels > 7% in diabetic patients in 39% (45 vs. 32%, p = 0.1). Eighty-five percent were overweight (86 vs. 85%, p = 0.8), 37% were obese (41 vs. 31%, p = 0.01), and 10% reported currently smoking (17 vs. 3%, p < 0.01).

Conclusion

Although most CHD patients received the drug classes recommended by guidelines, treatment goals were frequently not achieved. Elderly subjects had a less favorable pattern, which may reflect multi-morbidity and weaker identification with treatment targets. National CHD prevention strategies should focus not only on enhancing lifestyle modifications and reaching treatment targets, but also on highlighting the different needs in older individuals.

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Title: Secondary Prevention in Younger vs. Older Coronary Heart Disease Patients—Insights from the German Subset of the EUROASPIRE IV Survey
Authors: Martin Wagner
Götz Gelbrich
Julia Kircher
Kornelia Kotseva
David Wood
Caroline Morbach
Rainer Leyh
Georg Ertl
Wolfgang Karmann
Stefan Störk
Peter U. Heuschmann
Publication date: 01-06-2018
Publisher: Springer US
Published in: International Journal of Behavioral Medicine / Issue 3/2018
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-017-9691-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Secondary Prevention in Younger vs. Older Coronary Heart Disease Patients—Insights from the German Subset of the EUROASPIRE IV Survey

Abstract

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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