The last two decades have seen improvements in cardiovascular disease (CVD)-related mortality, but there is recent evidence of plateauing, or even increases, in mortality rates. There are well known relationships between CVD and a number of risk factors, including high cholesterol (hyperlipidemia), high blood pressure (hypertension), high blood glucose (hyperglycaemia), unhealthy diet, obesity, alcohol overconsumption, smoking and physical inactivity. The reversible nature of these risk factors provides a huge opportunity to prevent CVD events by improving risk factor treatment and promoting the adoption of a healthy lifestyle. Medical guidelines for both the primary and secondary prevention of CVD recommend specific treatment targets for these risk factors, but there are decades of evidence that these are achieved in a minority across different countries and health systems. Optimising primary and secondary prevention could significantly improve European CV health (CVH) with subsequent positive effects on individual and population health outcomes, healthcare systems and economies. This project identifies the benefits available, in terms of fatal CV events avoided, by optimising secondary prevention in those with established atherosclerotic cardiovascular disease (ASCVD) in seven European countries, including Denmark, France, Germany, Italy, Poland, Spain and the United Kingdom.
We aimed to answer four underlying research questions:
- What is the impact of improved secondary prevention in patients with pre-existing cardiovascular disease?
- How many fatal CV events can be averted in seven country populations by reducing risk factors including raised blood pressure levels, raised cholesterol levels, raised blood glucose levels and smoking?
- Is European cardiovascular data sufficient to determine the impact of improved risk factor control?
- How can the EU and EU Member States improve secondary CVD prevention for their populations?